Affiliates and the Peak Load Problem

Every EMS company needs two or three allies to which they can roll calls, in order to solve the Peak Load Problem.


The Peak Load Problem

Imagine you run an EMS company with three trucks.

You'd like to keep all your trucks busy all day, which means keeping a full call schedule... but not too full or else patients will be forced to wait. Therefore this is your ideal call schedule:

Calls Call Call
Call
Call Call
Call
Call Call
Call
Call Call
Call
Call Call
Call
Call Call
Time 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00

It's a nice, smooth, even distribution of calls. All three trucks can stay busy all day long. The calls come one or two at a time, leaving a bit of room for earlier calls to run late. It's perfect.

Unfortunately, it is usually impossible to rearrange patients' dialysis schedules, because the dialysis centers work so hard to keep their own schedules full. So if several dialysis patients end up clustered together, your call schedule then looks like this:

Calls Call Call
Call
Call
Call
Call
Call Call
Call
Call
Call Call
Call
Call Call
Call
Call Call
Time 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00

Three calls at 09:00. If there is any delay whatsoever -- and there always is -- then they will be late for their 10:00 pickups. Likewise the three calls at 13:00 and the closely following call at 14:00.

To make matters worse, there are also the random, unfortunately-timed trips to doctors' offices, as well as the last-minute work-ins. If you also provide ER transportation, then you've got to be always ready to send a crew straight over, lest the facility be required to make an expensive call to 911 rather than wait on you to free up a truck. Your daily call schedule may end up looking like this:

Calls Call Call Call
Call
Call
Call
Call
Call
Call Call
Call
Call
Call
Call Call
Call
Call Call
Call
Call Call
Time 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00

How do you cover those calls with just three trucks?

This is the Peak Load Problem.

It weighs on all EMS companies, but it weighs the heaviest on small EMS companies.

The smaller your fleet, the bigger the problem

As your customer base grows larger, the noisy peaky-ness of your call schedule will begin to smooth out. There will still be surges -- unexpected bursts of two or three additional calls -- but they are far easier to manage: with fifteen trucks in the field, there are always nearby crews that can be juggled. Whereas if you have just three trucks, and two of them are stuck downtown on wait-and-return calls, then you have nothing to juggle with.


It Helps to Have Part-Time and On-Call Employees

If you have spare trucks, then you can arrange part-time or on-call employees to help you cover the peak loads.

There may be EMTs and paramedics who live near your station(s), that can be contracted to come in only when needed. Your current full-time employees will probably know some people who would be good candidates. You can also hang around a busy dialysis center and pass out business cards to your competitors' crews as they come and go; it isn't poaching, you are simply offering them the chance to earn some extra cash on the side.

Wake-up call

On-demand/on-call crews will probably demand above-market rates (perhaps 20% higher)... and you'll need quite a few of them in your rolodex, because they will often be busy at their regular jobs. If you can find, say, ten on-call candidates, then you will always have one or two available at any given time.

This even works for ER calls. In order to respond immediately to an ER call at 08:30, send the truck that is standing by for a dialysis patient at 09:00, and call in the reserves to take the dialysis call, giving them time to get dressed and drive in.

Of course this solution requires you to have an extra truck that is maintained in good working order. Not everyone has that luxury.


You Need Allies, Even If They Are Competitors

The peak load problem means that all small and medium EMS companies need allies, who can cover their calls during a peak load.

Fortunately your competitors are suffering from the same problem (it is unavoidable) and so will be receptive to a call-sharing arrangement... assuming they don't already have several in place.

Verbal agreement is sufficient

An agreement like this does not require a written contract, or lawyers. It just needs one good phone-call, or an executive lunch, one owner to another. The two of you should agree on these points:

  1. We will each make the other our first choice when looking to roll a call, in order to maintain a balance of calls given versus calls received.
  2. We will not poach employees from each other.
  3. We will never perform any marketing at each others' contract facilities. Not even minor marketing, such as dropping off transport envelopes.
  4. We will each give the same excellent customer service at the other's facilities as we would give at our own.

If your ally breaks the rules once, an apology should be forthcoming. If he breaks the rules a second time, cut him loose and find another.

This can become a strategic alliance

After working together for a period and establishing trust, this relationship can become a strategic alliance, formalized in a written contract that allows advanced benefits such as:


Business lunch


Choosing Allies

The smaller your fleet, the heavier the peak load problem weighs. Therefore, when looking for allies, look for companies that are about the same size as you, or smaller.

Larger companies will be glad to take your rolled calls, and may not ever send any back. While that may seem "better than nothing", there is a hidden peril: after handling a few of your rolled calls, the large company's salespeople will visit your contract facilities. Their salespeople will saunter in to your crown jewel facility and say "Our crews have been here quite a few times in the last month, how did you find the service? Would you like to hear about our very competitive rates?"

Other things to consider when choosing an ally:


Rolling Calls is Easy in AngelTrack

AngelTrack's dispatch system was built with affiliates in mind. It is exceptionally easy for your dispatchers to assign, reassign, and unassign calls from your affiliates.

You can configure each affiliate's service level, headquarters location, and hours of operation. AngelTrack takes all of that into account when presenting a list of available affiliates to a dispatcher who is deciding how to assign a call. The chosen affiliate will receive an automatic email from AngelTrack giving the details of the call. Your affiliates can also use the Customer Portal to see a live dispatch board showing everything assigned to them -- now and in the future.

To learn more about how AngelTrack handles affiliate relationships, read the Affiliates guide.



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