ACHIEVING OPERATIONAL

ACHIEVING OPERATIONAL EFFICIENCYSponsored by

2ACHIEVING OPERATIONAL EFFICIENCY

EDITORrsquoS NOTEldquoWhen we waste dollars through inefficient practices we are not being good stewards to our patients our taxpayers or to our EMS missionrdquo writes Jonathan D Washko MBA FACPE NRP AEMD A reliable effective and efficient inventory management system can help an organization reduce costs limit waste improve employee relations and limit liability

This eBook presents strategies to provide for high quality operations while minimizing resource use through sound systems process engineering and leveraging technology Learn how lean conceptualizing can revamp medication standard medical consumables and serialized inventory tracking through asset verification ePCR recording and fleet management

I encourage you to read and share this eBook with your colleagues and begin a conversation about how your agency can improve asset management

Kerri Hatt editor-in-chief EMS1

VP OF CONTENTJon Hughes

jhugheslexipolcom

EDITORIAL DIRECTORGreg Friese

gfrieselexipolcom

EDITOR-IN-CHIEFKerri Hatt

khattlexipolcom

SENIOR ASSOCIATE EDITORRachel Engel

rengellexipolcom

GRAPHIC DESIGNGail Parker

gparkerlexipolcom

Sponsored by


TABLE OF CONTENTS

Big or small manage EMS inventory by lsquothinking leanrsquoBy Jonathan D Washko MBA FACPE NRP AEMD

Automating medical supply inventory managementBy Robert P Avsec

Successful EMS inventory management takes both hindsight and foresightBy Rachel Stemerman NRP MPH PhD Product Manager of Data Science and APIs at ESO

Is your logistics process efficientBy Tim Nowak BS NRP

040813

17


By Jonathan D Washko MBA FACPE NRP AEMD

When it comes to inventory management size matters

How you manage your supply and logistical workflows is usually dependent on call volume number of stations number of employees supply mix complexity and budget

Smaller organizations tend to marginalize this task onto the existing management infrastructure meaning it is part of the job for someone who may wear many hats ndash this may be a line supervisor who is also a field paramedic a fleet

coordinator a supply coordinator and a station coordinator all rolled up into one

On the other hand larger organizations will typically have a dedicated department and staff to specifically handle the supply and logistical needs of the organization The structure is typically based on the type of EMS system design you operate under ndash fire private third service hospital PUM etc ndash and if you are subsidized or rely purely on revenue from billings to operate

Money mattersWhile size matters in terms of workflows and marginal or dedicated infrastructure there

Whether you own one ambulance or 1000 EMS agencies should aim for high quality while using the least amount of resources

BIG OR SMALL MANAGE EMS INVENTORYBY lsquoTHINKING LEANrsquo


are many common best practices that any organization can use to provide a lean mean supply and logistics machine

Why is this important

In both large and small EMS organizations dollars count Our ability to convert dollars into service through economic efficiency is one of the most misunderstood yet most valued commodities that management touts as part of their mission

Lean thinking is providing for the highest in quality reliably and consistently while using the least amount of effort or resources possible to

obtain that goal It is something we all can do whether we have one ambulance or 1000 Some may consider these goals diametrically opposed and unobtainable but they can be achieved through sound systems process engineering and leveraging technology

Knowing inventory usage expiration dates par levels and distribution management is key to lean process success Learning to leverage this insight to your lean advantage is the next challenge

Think leanLean process is all about minimizing the amount of time energy effort and money that goes into a particular mission ndash in this case supply and logistics

Thinking lean aims to for example recognize that a process that takes 10 steps and three hours to complete could be reduced to three steps in one hour by completely revamping how the

When we waste dollars through inefficient practices we are not being good stewards to our patients our taxpayers or to our EMS mission


task is managed through the organization (while improving or maintaining quality)

Take this concept and apply it to your existing supply and logistical processes Are there things you could do to reduce waste par levels or loss I have yet to see a process that could not be improved in some way Itrsquos all about thinking differently and breaking the unwritten rules of the organization In other words getting out of the ldquowersquove always done it that wayrdquo style of thinking

This line of thought is what gave birth to supply and logistics best practice concepts such as speed loading snap packs service point inspection systems cabinet sealing systems and more The ideas behind these types of systems are to reduce waste while simultaneously improving quality and reliability

Get automatedUsing technology is another important way an agency can embrace lean processes In todayrsquos

cloud-based world information systems that used to be out of the reach for small EMS providers are now available at a fraction of the cost and usually require little-to-no up-front capital investment to acquire

Cloud-based systems can provide the business intelligence you need to effectively manage your inventory processes and systems ndash yielding lower costs through less waste and lower par levels Inventory scheduling and electronic patient care reporting systems can be used to track usage manage inventory allow for remote online ordering and track dates all of which improves workflow and inventory intelligence

With a new thought process and improved data about your inventory itrsquos time to start designing new workflows to make the process leaner and more efficient

For example if you know your usage of a particular item is consistent set up an automated ordering process for that item using reasonable


par levels If you find that an item is low-usage and quickly expires try to target which station has a higher probability of using that item and move it from a low-use station to a high-use station before it gets stale

Your true usageAlso make it a practice to determine your true usage and identify loss through auditing ePCR records that allow quantification of supplies used For example on reading a chart where a patient received a 12 lead and an IV you know how many electrodes IV catheters IV start packs tubing fluids etc were used

With this type of audit you can extrapolate what your true usage is and compare it to what you are consuming The delta between these two measurements shows what could be waste left or poor documentation and pinpoints where opportunities for improvement may lie

With this information you can identify any weak spots and use lean process improvement concepts to fix what you and the data foundThinking lean can not only improve your supply and logistic processes in organization Itrsquos a concept that can be applied to all aspects of managing your organization ndash large and small

About the author

Jonathan D Washko MBA FACPE NRP AEMD is the assistant vice president for the Center for Emergency Medical Services for North Shore LIJ Health System in New York City and Long Island New York and the founder of Washko amp Associates LLC

He is involved at the national level with various industry groups and serves as director at large and as a Mobile Integrated Healthcare Committee member for NAEMT


AUTOMATING MEDICALSUPPLYINVENTORY MANAGEMENT


By Robert P Avsec

Todayrsquos complex EMS environment requires administrators to constantly juggle issues like tightening budgets drug shortages strict governmental regulations and a highly engaged and connected staff ndash all while operating in a litigious society Using yesterdayrsquos approach to inventory management and supply logistics is no longer an acceptable practice

There are several significant aspects to automated inventory control and management for todayrsquos EMS agencies in both the public and private sectors Having a reliable effective and efficient inventory management system can help an organization reduce costs limit waste improve employee relations and limit liability It can also positively impact patient care by having the right supplies and drugs available when needed

Private-sector EMS agencies have long used automated solutions to improve their fiscal bottom line by reducing costs and limiting waste Increasingly public-sector EMS agencies are seeing a similar need as their local funding from government or donations from stakeholders have declined or remained stagnant

EMS agencies across the board are also facing more demanding requirements for reimbursement from medical insurance companies Medicare and Medicaid for the supplies and drugs used when rendering patient care The healthcare environment is rapidly changing with reduced reimbursements new government regulations and an increased focus on compliance This added complexity makes managing billing and coding in house much more challenging

Inventory control and management software benefitsCurrent and developing technologies in inventory control can enable EMS agencies to improve both their efficiency and effectiveness in a variety

of ways including but not limited to

bull Providing real time visibility into stocking levels of biomedical devices supplies and medications in stock rooms and aboard ambulances and fire apparatus

bull Ensuring accountability for supplies on an ambulance or fire apparatus at the beginningend of a tour of duty

bull Tracking controlled substancesbull Tracking expiration dates to decrease wastebull Avoiding ldquostockoutsrdquo by setting pars

minimumsmaximums for supplies to automate restocking

bull Decreasing shrinkage by tracking usage and highlighting discrepancies

bull Reducing your organizationrsquos liability associated with poor inventory management

bull Simplifying and automating your organizationrsquos reordering process

bull Optimizing inventories to reduce your organizationrsquos cash-in-inventory

Inventory control to prevent narcotics diversionDiversion is the theft of any pharmaceutical to be sold or traded for personal gain In its simplest form detection of the loss of pharmaceuticals is a basic inventory control function The three variables are replenishment of warehouse or central inventory documented usage and replenishment of in-station or in-ambulance inventory Inventory depletion is predictable over time and can therefore be forecast as well

Here is a common sense simplistic example of monitoring inventory You order what you use When ordering medications at the rate you use them and by using percentages of increase the variances become highly recognizable Use percentages because in drug inventories units may not raise a flag

Reduce liability simplify supply ordering decrease waste and prevent drug diversions with inventory control management


For example an increase of 10 units of morphine in this monthrsquos requested inventory for Station 6 may not seem out of line but if those 10 additional units of morphine represent a 15 increase over whatrsquos previously been ordered each month that might be cause for a closer look

Electronic supply trackingAn electronic system streamlines inventory management by enabling an agency to track the life cycle of any item from the initial receipt of an item at the warehouse to the distribution of the item into the supply chain (eg sending it to an EMS station) to use of the item for patient care Key inventory management and control functions that lend themselves to electronic tracking include

1 Managing inventory of standard medical consumables Keep it simple by electronic tracking standard inventory items by location number and quantity Track a variety of standard stock inventory like bandages gauze and more

2 Tracking medication inventory Categorize medication using batch-lot numbers to efficiently and effectively keep track of expiration dates Having an accurate picture for medication ins and outs as well as on-hand quantity and reorder levels can ensure that each EMS vehicle has the right medication inventory on board when an emergency strikes

3 Serialized inventory tracking Track chemicals and oxygen tanks individually using serial numbers to meet government mandated requirements and to better prepare yourself when serialized inventory items are needed

Electronic medication dispensing systemsKeeping medications under lock and key is not the most effective strategy for managing and controlling how those medications are used Electronic medication dispensing systems provide benefits for both EMS providers and


managers Providers benefit from

bull Secure automated access to narcotics and supplies

bull Better adherence to controlled substance policies

bull Intuitive software that accurately and completely documents usage

bull Integration of usage into the patient carebilling report

The managementownership benefits of an electronic medication dispensing systems include improvedbull Compliance with state and DEA regulations

for medication storage and dispensingbull Inventory control and dispensing of narcoticsbull Control of EMS provider access rightsbull Inventory tracking and documentation of

drugs used in patient carebull Billing accuracy for medications used in

patient careOne of the top components of inventory control and management is biometric security which uses an individualrsquos biometric fingerprint to verify all transactions This prevents someone

from making false transactions or supervisors or managers having to make sense of illegible paper signatures For added speed and security the biometric reader can also be used to log in to inventory control software

Information managementIn addition to inventory control and management todayrsquos electronic information management systems for EMS operations can include a host of other data collection and reporting features that improve an EMS agencies efficiency and effectiveness One example is performing vehicle inspections with an electronic check sheet If the inspection check sheet is integrated with inventory management and fleet maintenance software it can greatly enhance an agencyrsquos operational intelligence By replacing time-consuming paper check sheets crew members can be more accountable for supplies and equipment All information captured during the inspection processes can be used to manage and report on an agencyrsquos operations performance and needs

Fleet managers can receive information including vehicle mileage operating hours and any


repair orders in real time This makes planning scheduled maintenance and handling off-schedule repairs much easier

Another example is the use of a web-based inventory check sheet to conduct inventory of on-hand supplies Expiration dates on medical supplies are also captured to ensure that inventory is safe and ready for administration On-hand inventory is balanced against par stocking levels to automatically generate supply requests Optimally those supply requests are sent electronically to the supply room and processed based on an agencyrsquos operational procedures

Asset verificationThe equipment used by EMS providers to provide patient care particularly biomedical equipment such as defibrillators and medication pumps represent a significant financial investment by the agency Keeping track of that equipment as it moves through the operation is a critical risk management activity

Electronic asset tracking enables end users to verify that equipment checked out to a station or vehicle is indeed at the location or report the missing equipment If equipment is subsequently located they can add it to their inspection and automatically transfer ownership to the new location or vehicle allowing missing assets and assets in motion to be recovered If an asset requires maintenance the user can also record the maintenance while in the field using the check sheet

Logging supplies by callUsing electronic reporting also enables the EMS provider to capture the supplies used on a per-call basis Crew members can enter the ePCR number and enter the supplies used on the call Once completed the vehicles inventory is updated and a supply request is created These electronic call records can later be used to report on supply usage and matched up with an agencyrsquos ePCR records for quality assurance reviews

How to buy inventory management softwareBefore purchasing any software vendors product it is useful for an agencyrsquos leadership to conduct a self-assessment to answer some key questionsbull Why do we need to collect and analyze databull What data should or must be collectedbull Who will be responsible for entering the databull How will the responsible parties enter the

data

About the author

Battalion Chief Robert Avsec (ret) served with the Chesterfield (Virginia) Fire amp EMS Department for 26 years He was an instructor for fire EMS and hazardous materials courses at the local state and federal levels which included more than 10 years with the National Fire Academy Chief Avsec earned his bachelorrsquos degree from the University of Cincinnati and his masterrsquos degree in executive fire service leadership from Grand Canyon University


By Rachel Stemerman

Attempting to manage EMS medical supplies without the benefit of realistic demand forecasts and insight into replenishment patterns is like building a house on a weak foundation Itrsquos bound to fail and can wreak havoc on your EMS agency

Without a strong inventory management system paramedics and EMTs are more likely to run out of the supplies they rely upon to do their jobs While they scramble to locate stock precious time is lost and frustration and dissatisfaction build On the flip side in an effort to prevent stockouts agencies may overstock medical supplies Unfortunately finding a specific item within overstuffed cabinets and bags can be difficult and may cause breakage and waste In addition the risk of a medication expiring is much

higher when too much is ordered

The best way Irsquove found to avoid these pitfalls is to build a strong foundation for your inventory management system ndash one that can be transformed into a useful framework for making smart inventory management decisions

Data-driven forecastingInventory forecasting (also known as demand planning) utilizes historical data on usage including peak periods to predict future inventory requirements Itrsquos important to consider seasonal trends for items thatrsquos use is related to normal weather patterns such as albuterol which tends to be administered more frequently in the spring and summer when pollen and humidity are at their highest levels Forecasting the supplies necessary for future use should also factor in

5 steps to using forecast data to determine par levels and a structured framework for managing EMS medical supply inventory

SUCCESSFUL EMS INVENTORY MANAGEMENT TAKES BOTH HINDSIGHT AND FORESIGHT


replenishment data such as availability timing and delivery patterns

But itrsquos not just the end result that is beneficial the demand planning process itself offers meaningful insights While it is important to align forecasts with organizational goals (for example lean inventory management initiatives) the goals themselves become more realistic and achievable when informed by accurate forecasts

Supply chain challenges such as delivery delays and sporadic shortages should factor into the forecast equation and this quantification may provide insights that lead to beneficial decisions For example after exposing delivery and availability issues with a particular supplier a more reliable source may be identified

Improved EMS inventory management forecasting can also create operational efficiencies as well as substantial cost savings via a reduction in wasted supplies and inventory carrying costs

Using forecast data within par levels is the backbone of a structured framework for managing EMS medical supply inventory The idea is to maintain inventory between the minimum and maximum par levels using the minimum as the reorder point and the safety stock as a buffer until the items are replenished

Setting par levels Step 1 Gather the historical data down to the item level with respect to usage and replenishment rates and patterns Then put it all into a single spreadsheet or possibly one for each major category of supplies

Step 2 Determine the average minimum and maximum daily usage based on that data Many agencies experience fluctuating call volumes based on cyclical and occasionally unpredictable influences Although it varies by community these contributing factors may include holidays public events dangerous weather conditions influxes and exoduses of residents and (of course) pandemics

Step 3 Set the average and maximum lead times (the period between ordering and receiving an item) as well as the safety stock which is derived from both the daily usage and lead time figures Consider scenarios in which weather affects transportation or when supplies prone to shortages are backordered

Step 4 Set a reorder quantity factoring in

bull Volume discount price points Ordering at higher quantities can be cost effective assuming other considerations (such as shelf life or shelf space) donrsquot outweigh the savings

bull Carrying costs and tolerance Some agencies have budgets that require an especially lean approach to inventory while others may prefer to carry more excess (for example of epinephrine) to be on the safer side Itrsquos the difference between setting a higher max par or a more conservative one

bull Desired buying schedule or delivery frequency Where staff availability or other considerations make a specific day of the week or frequency preferable for either purchasing or receiving you may want to adjust par levels to accommodate them

Step 5 Use the above figures to calculate par levels per the below formulas

The payoffWhile therersquos no doubt that forecasting demand and setting par levels based on as much actual data as possible will be more time consuming than basing them on educated guesses there are so many benefits to reliable forecasting that it is well worth the extra effort In a nutshell better data translates into faster smarter inventory decisions that improve operations save money reduce waste and improve accountability

Equipped with more accurate demand planning your agency can better manage the medical supply logistics lifecycle Utilizing a par level framework for procurement decisions takes the guesswork out of them so you can maintain steady and optimal inventory levels This means


EMS providers will have the supplies they need readily available when and where they need them In turn EMS providers and staff will be more efficient and less frustrated

Because stock levels remain under control your agency will rarely need to rush an order which means yoursquoll spend less on expedited delivery charges Avoiding the overstocking of perishable items will translate into less waste Improving efficiency and minimizing staff and vehicle downtime can enable you to do more with less Finally with greater accuracy and reliability you can provide better reporting for improved internal and external accountability including better aligning stock levels with organizational goals and easing regulatory compliance

Of course therersquos no reason to simply take my word about all the reasons you should take the time to improve your demand planning A handful of metrics can provide ample proof of its impact

Two key performance indicators are inventory days on hand and inventory turnover When either is too high or too low better inventory management should produce movement in the desired direction

These next two metrics may provide the clearest evidence Annual expedited delivery charges should drop because the better inventory is managed the less reason there will be to rush resupply orders Similarly an inventory variance report should reveal lower shortfalls due to higher rates of medication utilization (fewer expired meds) and less item damage and loss

Inventory software makes it workStill itrsquos tough to keep track of the par level and expiration status of every medical supply when relying on something like a spreadsheet Thatrsquos where inventory management software can make a big difference

Specifically designed to help EMS agencies regain control of their medical supply inventories software like ESO Inventory provides visibility into all locations and improves your inventory position

MAX PAR = Minimum Par + Reorder Quantity ndash Minimum Lead Time DemandExploits volume discounts and process efficiencies while staying within max stock tolerance levels

Minimum Daily

Usage

Average Lead Time

x

Because when forecasts are accurate and data is delivered in a way that truly streamlines decision-making the savings add up

MIN PARREORDER POINT =Average Lead Time Demand + Safety StockAverage

Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )


It starts with a bulk import of par levels rather than manually entering each one This saves time and prevents mistakes By filtering items by par status managers can more easily take on bulk tasks such as ordering upon review of all below-par items Purpose built EMS inventory software is also smart making suggestions upon the completion of an action to facilitate fast responses to key indicators For example ESO Inventory suggests a transfer or new order when an item falls below par It also provides an Action List which is a birdrsquos eye view of item stock at each location with related par expiration stocking and replenishment statuses

With real-time insight inventory management software your staff can make timely well-

informed ordering decisions and can ensure that critical medical supplies will be available to emergency care providers whether theyrsquore at the station or out on a call

About the author

Rachel Stemerman is the product manager of data science and APIs at ESO Prior to joining ESO she completed her PhD in Health Informatics at the University of North Carolina as a National of Library Medicine fellow where her research focused on information extraction machine learning and data visualization for clinical decision support Prior to entering her PhD program she was the quality improvement coordinator for Orange County EMS where she currently is an active paramedic


By Tim Nowak BS NRP

EMS agencies ndash big and small ndash receive countless boxes of supplies medications and other disposable goods each month week or even day For some therersquos a seemingly revolving door of supplies coming in and going out within any workweek process For others you can almost see the dust collect and the expiration date gloomily near as yet another 24-gauge angiocath meets its expiration date

While some expiration dates might be inevitable (like with your cricothyrotomy kits) and thatrsquos not necessarily bad it begs us to ask the question of

whether or not our logistics process is efficient Are we minimizing an itemrsquos ability to become expired by tracking its shelf life and rotating it around to busier units before the panic of expiration sets in Are you overstocking ndash which financially equates to overspending How much is too much How much is too little

Thinking about our processes from the field crewsrsquo perspective ndash the end user ndash it makes sense to think backwards using the patient care report (PCR) to track an itemsrsquo use

For busy agencies and systems that arenrsquot able to do a weekly physical tally in their supply room (or warehouse) itrsquos imperative to utilize software tools to help you manage your equipment and supply (logistics) stocks in order to maintain any form of efficiency Once again boxes come in regularly but how do you determine what gets shipped in those boxes

Reducing operational costs through data inventory management

IS YOUR LOGISTICS PROCESS EFFICIENT


2 scenarios for product rotationPut yourself in the crewsrsquo bootsYou respond to a call for a respiratory distress patient In the residence you don your gloves and medical mask (items 1 and 2) assess the patient and apply a nasal cannula with carbon dioxide collection capabilities (item 3) and then begin treating him with a nebulizer (item 4) with aerosolized albuterol (item 5) and ipratropium bromide (item 6) The patient gets loaded into the ambulance where you obtain IV access using a catheter (item 7) start kit with included extension set and saline flush (item 8) You upgrade the patient to continuous positive airway pressure (CPAP) (item 9) and acquire a 12-lead ECG for interpretation (patches ndash item 10) You draw and administer methylprednisolone (item 11) (3 mL syringe ndash item 12 blunt needle or 18-gauge needle ndash item 13 alcohol wipe ndash item 14 saline flush ndash item 15)

When you think about it thatrsquos a lot of items ndash and data Now how do you keep track of all of this

Tracking expiration dates and the usage of supplies equipment and medications either immediately upon use or at the beginning of the next shift can populate reports indicating which items no longer exist within your system

While in most cases itrsquos the crewsrsquo responsibility to restock the unit letrsquos talk about the people behind the curtain ndash those tracking supply use and placing new orders With all this information captured in the PCR it only makes sense for one of two things to happen the PCR communicates with your supply ordering software or your PCR generates a report that is your supply ordering list

The first scenario is quite seamless as the PCR software immediately notifies your vendor of supply use as soon as the complete button is selected so that a weekly order can be automatically submitted The second option involves a few more hands-on steps but nonetheless itrsquos still quite an efficient process as your logistics folks receive an automatic report highlighting all of the consumed equipment for a given time period From here your logistics team can verify that what was used has been sent back out to the crews (thus creating a vacancy to be re-filled on the next supply order) All of this depends upon data If your crews donrsquot enter the correct data then the system canrsquot analyze the right data (and produce accurate results)

Efficiency is the key to minimizing waste Yes some medications and equipment items will still reach their expiration dates but through an efficient system of tracking and rotating these items yoursquore much more likely to reduce the quantity wasted by keeping a more fluid and dynamic (rather than static) system in place

About the author

Tim Nowak BS NRP is the founder and CEO of Emergency Medical Solutions LLC an EMS training and consulting company He has nearly two decades of experience in the emergency services industry as a career firefighter paramedic and critical care paramedic His background includes nearly a decade of company officer and chief officer level experience in addition to training content delivery and program development spanning his entire career


When it comes to community health Make every dollar count

VISIT ESOCOMGET-INVENTORY

Spend less time getting ready and more time being ready Take control of your EMS inventory with ESOs latest application ESO Inventory

For more info and to request a demo from our EMS team

REFRESHINGLY SIMPLEINVENTORY MANAGEMENT

Reduce waste from medication expiration

Save money by transferring instead of reordering

Save on costs by prioritizing best prices or negotiated rates

Benefits of ESO Inventory


4 WAYS TO BETTER MANAGE EMS INVENTORYHaving a good system can help reduce costs improve EMS morale and lead to better patient care

UNDERSTANDING VALUE AND HOW IT RELATES TO EMS COSTSEMS should utilize a data-driven approach to value management that considers both quality and costs

HOW TO BUY

ePCRKey steps for product selection purchasing and implementationHOW TO BUY EPCR (EBOOK)

Download this EMS1 ePCR buying guide to learn key steps for product selection purchasing and implementation

DRUG SUPPLY MANAGEMENTHere are the top questions medical directors operation directors and quality assurance directors need to answer before purchasing EMS drugs

eNewsletters Training VideosProduct Deals

ESO is dedicated to improving community health and safety through the power of data Since its founding in 2004 the company continues to pioneer innovative user-friendly software to meet the changing needs of todayrsquos EMS fire departments and hospitals ESO currently serves thousands of customers throughout North

America with a broad software portfolio including the industry-leading ESO Electronic Health Record (EHR) the next generation ePCR ESO Health Data Exchange (HDE) the first-of-its-kind healthcare interoperability platform ESO Fire and ESO FIREHOUSE Software for fire departments

ABOUT THE SPONSOR

MORE ON


EDITORrsquoS NOTEldquoWhen we waste dollars through inefficient practices we are not being good stewards to our patients our taxpayers or to our EMS missionrdquo writes Jonathan D Washko MBA FACPE NRP AEMD A reliable effective and efficient inventory management system can help an organization reduce costs limit waste improve employee relations and limit liability

This eBook presents strategies to provide for high quality operations while minimizing resource use through sound systems process engineering and leveraging technology Learn how lean conceptualizing can revamp medication standard medical consumables and serialized inventory tracking through asset verification ePCR recording and fleet management

I encourage you to read and share this eBook with your colleagues and begin a conversation about how your agency can improve asset management

Kerri Hatt editor-in-chief EMS1

VP OF CONTENTJon Hughes

jhugheslexipolcom

EDITORIAL DIRECTORGreg Friese

gfrieselexipolcom

EDITOR-IN-CHIEFKerri Hatt

khattlexipolcom

SENIOR ASSOCIATE EDITORRachel Engel

rengellexipolcom

GRAPHIC DESIGNGail Parker

gparkerlexipolcom

Sponsored by


TABLE OF CONTENTS





040813

17



































About the author






By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON


TABLE OF CONTENTS





040813

17



































About the author






By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON



































About the author






By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON

























About the author






By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON















About the author






By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON






About the author






By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON




By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON


By Robert P Avsec













































data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON




























data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON





















data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON








data

About the author



By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON


By Rachel Stemerman

































Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON


























Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON










Minimum Daily

Usage

Average Lead Time

x



Lead Time

Average Daily

Usagex

Max Daily

Usage

Max Lead Time

x( ) ndash (Average

Daily Usage

Average Lead Time

x )





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON





About the author



By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON


By Tim Nowak BS NRP















About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON








About the author















HOW TO BUY







ABOUT THE SPONSOR

MORE ON














HOW TO BUY







ABOUT THE SPONSOR

MORE ON




HOW TO BUY







ABOUT THE SPONSOR

MORE ON

Documents

ACHIEVING OPERATIONAL