Call Volume by Day of Week

The Call Volume by Day of Week report analyzes dispatch records in the recent past in order to predict call volume in the future.

Recent call volume is broken down by service level, by day of the week, and then by time of day. So, the chart can show you -- for example -- how many simultaneous stretcher calls you have had at 8:00 AM on Mondays. This information can then inform your staffing decisions.

The report excludes all of the following:

The report includes calls marked ✔ Delegated to Affiliate, on the understanding that these represent call volume that you would prefer to handle in-house.

Graph with annotations

The candlestick chart conveys five pieces of information for each 30-minute time period:

Staffing Level and Service Levels

Pay special attention to this filter setting:

Show the number of active shifts which were ☑ greater than or equal to or ☐ equal to the selected service level

This filter determines whether the blue dotted line includes shifts that were above the selected service. For example, when viewing BLS activity, this filter setting determines whether the dotted line includes ALS and MICU shifts... potentially overstating the level of staffing.

The chart cannot fully visualize the ability of higher-level units to cover lower-level calls but not vice versa. You must review the higher-level demand plots (BLS, ALS, MICU) separately, then look at the lower-level plots (car, gurney, WC, BLS) with and without showing higher-level shifts, to get a sense of whether your higher-level units will have enough free time to cover any overflow of lower-level calls.

Interpretation Examples

To help you learn to interpret the graph, here are some examples.

Sample 1: Understaffed

Sample 1

This operation is understaffed in the morning until about noon: notice that the average call volume (heavy black line) and the confidence diamonds are both high above the average staff level (dotted blue line). After noon, the staff level rises to hover in the correct zone (between the average call volume and the confidence diamonds).

From 21:00 onward the operation appears to be overstaffed by two units, but this is just crews sitting at the station finishing their reports and cleaning their trucks. Such things should be done throughout the day (in-between calls) instead of in the evening, since AngelTrack allows crews to work on their reports while in the field.

Sample 2: Very small operation

Sample 2

This EMS operation has only three trucks, and is attempting to cover a dialysis hump while also catching surges of ER calls that arrive erratically throughout the day. It looks like they have two front-line ambulances plus a reserve ambulance (perhaps older and less reliable) that participates on some days as a third shift.

Covering at 90% confidence is done for the purpose of growing the business by being always available... but it requires the up-front investment of fielding additional crews that may or may not get any calls.

Sample 3: Nearly perfect staffing

Sample 3

This chart shows an EMS operation whose staffing levels are razor sharp, carefully tracking average call volume throughout the day, and then rising to cover the confidence diamonds for the evening surges.

As noted earlier, the apparent mild overstaffing at the end of the day is crews sitting at the station, finishing their reports and cleaning their trucks. This can be somewhat -- but not completely -- reduced by pushing crews to finish their reports while in the field, in-between calls.

Sample 4: Overstaffing, dialysis humps

Sample 4

This sample shows the characteristic humps of a dialysis caseload, as per usual. However, it is seriously overstaffed: the dotted blue line floats high above the confidence diamonds for most of the day. This is terribly expensive, but it might be intentional: the company may be using investment capital to operate overstaffed and therefore highly responsive, in order to attract new business from nursing homes, hospitals, and freestanding ERs.

In the evening the crews are probably looking busy, finishing their reports and cleaning their trucks, but that can be reduced by requiring them to work on their reports while in the field throughout the day.

Sample 5: Dialysis humps, afternoon overstaffing

Sample 5

This chart shows the characteristic humps -- spaced four hours apart -- of an EMS operation under a heavy dialysis caseload. Staffing levels after noontime are greatly excessive: the company prematurely ramps up staff (dotted blue line rising at 11:30) for the evening surges (diamonds rising at 16:00).

Between the 8:00 rush, the noon rush, and the 16:00 rush, there are too many units on staff, but there is probably no way to solve this problem unless you can persuade your dialysis centers to rearrange a few patients' chair times. Dialysis centers usually refuse to do so, unless you can come to them with multiple patients who are simply swapping chair times between them.

Sample 6: Confident coverage

Sample 6

This operation is staffing to cover the confidence diamonds, in order to be responsive to its customers. From 16:00 to 18:30, staff levels cannot rise to follow the confidence diamonds because the company only has nine front-line ambulances -- leaving two in reserve in case of a breakdown or accident.

From 20:00 onward the operation appears to be overstaffed by two units, but this is just crews sitting at the station finishing their reports and cleaning their trucks. Such things should be done throughout the day (in-between calls) instead of in the evening, since AngelTrack allows crews to work on their reports while in the field.

Sample 7: Tight staffing, no surge coverage

Sample 7

All day long until 16:00, this operation staffs at exactly its average call volume, leaving no spare units to handle surges. That means some ER calls will be missed, and last-minute work-ins will be delayed many hours. At 16:00 staff levels rise to better answer the surges.

By 19:30 it has become slightly overstaffed, but as with the other samples, the end-of-day excess staff is probably just crews sitting at the station, finishing their reports and cleaning their trucks.

Extra evening shifts are also sometimes intended to woo new business from a local freestanding emergency room, which usually has a surge of business after the dinner hour and will be grateful to have an EMS company on hot standby.

Look at Several Confidence Intervals Before Making Staffing Decisions

Before making any decisions about staffing levels, look at several different confidence intervals first.

You may discover that a small reduction in confidence -- say from 90% to 80% -- can yield a significant savings in labor costs. The tradeoff is an increase in late pickups and late dropoffs, and a decrease in the number of ER calls you won by having a unit available.

Customers are not willing to pay for 100% on-time service

This chart speaks to a broader question that all EMS companies face: What is an acceptable rate of late pickups / late dropoffs?

Few customers are willing to pay what it would cost to field the large number of crews needed to reach 99% on-time performance. In fact, most customers have never thought about the issue at all, or what it would cost them for their EMS company to meet that lofty goal.

It may be necessary to have a frank conversation with your contracted facilities and with your frequent-flier patients and their families. Explain the problem of paying crews to sit around just in case. Provide them reassurance that you continuously monitor your operation's performance numbers in order to strike the right balance between saving money, driving at a slow and careful speed, and arriving on-time.

This is an important narrative to impart to your customers, to set expectations and properly frame the occasional lateness in terms of labor costs.

AngelTrack can help

AngelTrack provides the monitoring tools and charts to manage your late pickup / late dropoff rates, in order to keep them within an acceptable range. If called to the carpet to answer for complaints about lateness, print the reports and take them with you. If the numbers are good, the reports will exonerate you; if the numbers are not good, the reports will show you are monitoring the problem and are taking it seriously. Relevant reports include:

Remember also the Customer Portal, which your facilities can use to monitor their call schedule and the progress of assigned crews.

AngelTrack Help Index - AngelTrack Support