Making sound investment decisions

In well-run services, fractile performance improvements do not come cheaply. A one percent gain in an eight or nine minute response target may cost millions of dollars. Moreover, it is rarely clear where that money should be best spent. The first step is to recognize and understand the wide range of interventions and investments, and then to evaluate the benefits of each.

Performance issues at a glance

We have categorized a number of performance issues into the following groupings:

 

Structural

  • Road congestion
  • Call growth
  • Suburban sprawl

Strategic

  • Insufficient stations
  • Poor station location
  • Insufficient station capacity
  • Insufficient unit-hours
  • Insufficient fleet size
  • Long hospital waits

Operational

  • Evaluation times
  • Dispatch times
  • Chute times
  • Redeployment gaps
  • Scheduling gaps

Some of these issues can be addressed quickly and inexpensively, whereas others are difficult to even influence. By using something similar to the above table, you can get better sense of the breadth of interventions (keeping in mind this is only a subset), and you can be more creative in your approach to performance improvement.

The results are often surprising

Below are two nearly identical cities, but with very different cost-benefit profiles, lets look at how the performance improvements vary:

Intervention

  • Six-second reduction in average chute times
  • Ten-minute reduction in hospital turnarounds
  • One additional optimally placed station
  • One additional 24-hour staffed unit
  • Ten percent reduction in total call volume

City A

  • 1.0%
  • 1.2%
  • 0.3%
  • 0.8%
  • 1.2%

City B

  • 1.0%
  • 0.8%
  • 1.5%
  • 0.3%
  • 0.6%

As you can see, the best interventions in City A revolve around unit availability (hospital times, units on the street). Conversely, improvements in City B are highest from adding stations.

The ability to compare the benefits of various interventions is crucial in making sound investment decisions.

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