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12 NOVEMBER 2017 | EMSWORLD.com T he benefits of system status man- agement (SSM) have been hotly debated, with some extolling the virtues of efficient resource utili- zation as a hallmark of high-performance/ high-value EMS. For others it's a bane that leads to crew fatigue and delayed response times. Mecklenburg EMS Agency (Medic) in Charlotte, N.C., has mastered the art and science of SSM, achieving a balance between system performance and crew satisfaction. Here's what it takes to use SSM effectively. Basics of SSM At its core SSM is exactly what the term implies: a process used to manage a sys- tem. Management is an active process of transforming inputs (people, resources) into outputs (patient care, response times). Every EMS system is managed, but they can be managed differently. One way to manage a system is to use a static deployment model, producing the same number of resources throughout a 24-hour period placed in fixed locations. An alternative way to manage a system is to be flexible in your deployment strategy, producing the number of resources likely needed to meet anticipated demand dur- ing a given period over a given geography. Jack Stout, the economist credited with first describing the concept of system sta- tus management in EMS, believed using resources effectively creates value in EMS. The term SSM is used to describe the pro- cess of refining EMS resource management and utilization to improve patient outcomes and reduce the cost of EMS delivery. When managing a system, it's important to understand what your organization pro- duces. EMS agencies produce unit hours; a unit hour is composed of four ingredients: staff, supplies, equipment and a ready-to- deploy ambulance (or fire response unit, etc.). When considering flexible deploy- ment of unit hours, there are essentially two components to consider: temporal and geospatial. The temporal component addresses the "how many and at what time?" question. The development of a unit-hour production schedule should be based on anticipated demand. In high-volume EMS systems, there are often patterns to call volume. Call vol- ume is generally higher when more people are moving about—morning and afternoon rush hours, lunchtimes and what we in EMS affectionately refer to as "bar-thirty," when drinking establishments close. These times typically also have traffic congestion (often discussed as impedance) that makes it dif- ficult to get anywhere quickly. If you analyze your community's demand over time, you can plan your production strategy to pro- duce more unit hours when the predicted HIGH-PERFORMANCE EMS This is the 11th installment in a yearlong series of articles developed by the Academy of International Mobile Healthcare Integration (AIMHI) to help educate EMS agencies on the hallmarks and attributes of high-performance/high-value EMS system design and operation. For more on AIMHI, visit www.aimhi.mobi.. Why it's a good deployment strategy for high-value systems By Joe Penner and Jonathan Studnek, PhD, NRP Debunking the Myths of System Status Management Mecklenburg EMS Agency (Medic), Charlotte, N.C., has employed system status management to better allocate resources and thus manage the cost of readiness. (Photos: Mecklenburg EMS)