Author: <span>ORH Team</span>

Our managing director, Chris Polden, will be presenting at the Ambulance Leadership Forum on Wednesday 21 March at 8:30 am.  Chris’s talk ‘A Decade of Change: The Capacity Challenge’ will draw on ORH’s experience of working with Ambulance Services in the UK for over 30 years. During this time there have been substantial changes both in the demands placed on Ambulance Services and how that demand is dealt with. The presentation will highlight some areas where capacity has been released within the ambulance service over the past decade and where some constraints to efficient ambulance operations have been introduced. We hope you can join Chris for an exciting insight into ambulance data.

A key challenge faced by Fire & Rescue Services is tactical and operational preparedness. This focuses on the ability to have the right people, tools, vehicles and skills ready at the right time and place. As a result, organisations constantly search for better ways to predict and react in circumstances when normal operating function is disrupted.

Consultancy and technology companies, like ORH and FireServiceRota, have become allies in supplying innovative products to help Fire & Rescue Services solve these complex planning and mobilisation challenges.

Dynamic Cover for real-time support

To address these challenges, ORH developed the Dynamic Cover Tool (DCT) to assist decision-making in emergency service control rooms. The DCT gives clear insight into risk coverage and ensures resources are used as efficiently as possible.

The DCT achieves this by providing a real-time risk map to support officers in making appropriate back-up or standby moves for emergency response vehicles. For example, in situations where many resources are occupied responding to a major incident, or appliances being off the run due to maintenance or crewing deficiencies.

With the DCT, Fire Control can quickly decide if it is necessary to relocate available resources, so that appropriate standards of risk and response are maintained.

The DCT combines live status and AVL location data from CAD with historical demand and risk profiles.  This is used to calculate a real-time picture of current coverage and areas of high/low risk, however it cannot automatically consider the effect of future changes to the availability of resources. The potential drawbacks of this are:

1. Retained personnel can be scheduled to go off-duty, causing understaffing at their station and an increase in risk levels. While fully predictable, these problems are only visible in the DCT when they are already fully in effect.
2. Vice versa, performing an unnecessary standby move when a crewing deficiency at an RDS station is predicted to be resolved imminently.

Assessing risk and coverage therefore needs multiple data sources to take a proactive approach to monitor and maintain a high level of service delivery to the community.  One potential source is the Resource Management System, in which the schedules and rotas of firefighting personnel is managed; this must be flexible and reliable.

Predict and avoid understaffing

FireServiceRota is a flexible and reliable Resource Management System for retained and wholetime firefighters, making it possible to detect and prevent understaffing before it occurs, and informing Fire Control when availability will be restored.

FireServiceRota’s availability planning allows retained firefighters to schedule their intended rota, and to make exceptions if needed.

The software continuously monitors for crew availability based on the skills needed to operate different appliances. If the system detects (imminent) lack of a certain skills, it automatically asks unavailable members with the missing skills to become available.

In other words, FireServiceRota makes crewing levels highly predictable. This creates an opportunity to provide the DCT with information about predicted resource availability, instead of only real-time.

Preparation is better than reaction

The integration of DCT with FireServiceRota will allow Fire & Rescue Services not only to react to real time issues in coverage, but also to proactively detect cover shortages, allowing Control Rooms to prevent and prepare for reductions in coverage.

The integration will also allow authorities to predict when a station will be back in service, preventing unnecessary relocation of resources that would potentially put other regions at risk.

By planning and preparing for dynamic crewing levels using DCT and FireServiceRota, Fire & Rescue Services will possess ultimate control over their available resources, allowing them to deploy these in the most effective and efficient ways possible.

Having completed a major review of metropolitan ambulance cover in Greater Vancouver in 2014/15, ORH is excited to be back in British Columbia, this time to undertake a review for City of Richmond Fire-Rescue. The review requires in-depth analysis of the current service profile, before going on to model the optimum deployment of resources to meet current and future (10-year) projected demand. ORH’s detailed modelling approach uses demand, workload and geography to simulate potential options for change. The work is due to be completed by the end of November 2017.

In April 2017, consultants and data analysts from ORH attended The OR Society’s biennial Young to OR conference in London. Here they were involved in workshops, technique tasters and keynote sessions. They also attended talks from OR academics and practitioners on a wide range of subjects, including “Robust Optimisation”, “Working with Uncertainty” and “Decision Analysis for Decision Making”. ORH analyst Dr Lauren Petrie gave a presentation on “Modelling Access to Healthcare in the Australian Outback”, which related to ORH’s ongoing work with the Royal Flying Doctor Service. A team challenge was also undertaken which required participants to use inter-disciplinary networking and problem solving to design and present an OR solution to a real-life complex problem. ORH staff were placed in both the winning and runners-up teams.

We are pleased to announce that one of our developers, Dr Tom Boness, won the Practitioner and Researcher Poster competition at the OR Society’s 8th Simulation Workshop. Tom’s poster focused on modelling the resourcing requirements for Patient Transport Services (PTS). ORH has recently worked with two large PTS providers: HealthShare New South Wales and Yorkshire Ambulance Service NHS Trust. In these studies ORH assessed the impact of different demand and resourcing profiles on the timeliness of patient arrivals and post-appointment collections, and on resource utilisation. Tom’s challenge was to develop ORH’s PTS simulation software, PTSim, to plan efficient routes for a fleet of vehicles undertaking pre-booked and short-notice transport requests.  The results of this work with Yorkshire Ambulance Service can be viewed in the case study.