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Planning and scheduling in real time

13 October, 2014

CASE STUDY: How London Ambulance Service is using patient transport technology to help it maintain its best-in-class reputation.

London Ambulance Service NHS Trust (LAS) employs 4,500 staff in 70 ambulance stations to service an area of 620 square miles. Last year LAS handled over 1.5 million emergency calls and attended more than a million incidents.

In the same year LAS’ Patient Transport Service completed over 180,000 journeys to move non-emergency patients to and from their pre-arranged appointments. “We complete around 3,500 journeys a week” says LAS Senior Operations Manager Lisa Dickinson. “Our staff training is intensive but necessary, and there are very practical reasons for the gold standard we set. The London environment is very demanding but we still meet or exceed our timed patient delivery and collection targets, with typical KPI performance scores in the mid to high nineties. We like to think that our people are the best – but the technology we use also boosts their performance.”

LAS service uses 3tc Software’s Meridian Command patient transport system, which can plan and schedule unlimited volumes of traffic in real time and which has been shown to measurably improve patient transport performance. “In the past we used paper, which was slow and prone to human error” Lisa Dickinson explains. “Now all our crews have PDAs [personal digital assistants]. Once a journey has been allocated on Meridian Command it is transferred to the relevant PDA device using Meridian Mobile, with the crew receiving journeys electronically that can then also be updated in real time. And control can see what’s happening at any moment.”

This is a press-button environment. Once a journey has been allocated by LAS control they press a button on Meridian Command which sends it to the crew's PDA. The crew then press a button to indicate that they have started the journey; to indicate when they arrive at and leave each patient address; and to indicate when they arrive at and leave the hospital or other treatment centre. “Pressing buttons in this way at each stage of the journey gives us live information about where the crew are and what they are doing” Lisa Dickinson confirms. “This way of working also gives us great flexibility; so much so that we now generally only send crews their next journey. If we have an extra patient, or a crew member goes sick and we have to rejig some of the work, crews will be unaware of it: it happens within control, on the main Meridian system – the crew only know what their next job is.”

Meridian also gives some LAS clients (for example a community health trust consisting of some 60 separate London healthcare sites) the facility to make their own patient transport e-bookings using ‘Meridian Web’, a dedicated portal that eliminates the use of telephone, fax and email to do bookings, access transport information and produce statistics and reports. In this way clients can not only generate but also monitor the progress of their own patient bookings as they are fulfilled by LAS. All client users have to be fully trained by LAS before they can complete their own e-bookings.

Moving forward, LAS is considering a diversification into areas of A&E (accident and emergency) - though for patient support rather than blue light, emergency services. Lisa Dickinson says that Meridian would play a central role in that environment.

LAS is now also discussing a fleet management extension to Meridian with 3tc Software that would allow it to replace the separate database it already uses for fleet management, integrating its functionality within Meridian to maintain, manage and report on the status of its patient transport vehicles.

LAS will also be adopting 3tc Software’s autoscheduling Meridian upgrade. This technology is often regarded as the ‘holy grail’ of patient transport, due to the almost unlimited power and flexibility it brings to the process. “We’ve been looking at the idea of using autoscheduling to optimise the patient transport plan throughout the working day: being able to review it at certain points against what was planned to automatically rejig the plan,” Lisa Dickinson says. “In theory if we had a sudden and unexpected increase in bookings on the day, with autoscheduling the system would be able to automatically reschedule resources to manage the spike.”

“We have a great working relationship with 3tc Software” Lisa Dickinson concludes. “When we’ve asked for something or come up with a suggestion, 99% of the time they’ve gone away and thought about it and the next release it’s done. It’s been a relationship based on good teamwork, with both parties helping one another.”

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