London Ambulance Service Business Strategy - Research Paper Example

Running head: Strategy Evaluation: London Ambulance Service Strategy Evaluation: London Ambulance Service s Executive summary: The purpose of this report is to analyse the LAS Business Strategy, ascertaining its Business Objectives and the associated influencing factors, and the actual or potential application of technology in that Organisation and its IS/ICT/IM Strategy and/or Strategies and to recommend measures which could be taken in order to save the project from failure. "The London Ambulance service was founded in 1930 and went into the control of NHS in 1974. Since then, LAS has been managed by SouthWest Thames RHA. It is broadly divided into an Accident and Emergency Service (A&E) and a non-emergency Patient Transport Service (PTS). 2007 LAS covers a geographical area of just over 600 square miles and its area of operations are broadly coterminous with the London Fire and Civil Defence Authority and the Metropolitan Police. It is the largest ambulance service in the world. It covers a resident population of some 6.8 million, but its daytime population is larger, especially in central London. 2008 LAS carries over 5,000 patients every day. It receives between 2,000 and 2,500 calls daily; this includes between 1,300 and 1,600 999 calls." (Report of the Inquiry Into The London Ambulance Service, 1993) In order to reduce the manual workload the London Ambulance Service was planed to be automated. "The major objective of the London Ambulance Service Computer Aided Despatch (LASCAD) project was to automate many of the human-intensive processes of manual dispatch systems associated with ambulance services in the UK." (CAD Failure, 1992) PEST ANALYSIS [A] Political Economic Social Technical *Short time scale for such a large-scale project. *Pressure from the Government to meet the targets in the shortest time period. * Relatively small size of the firm awarded the contract. * Allocation of system budget. * Changes in the final layout of the project due to the lack of budget. *Lack of training for the crew in order to get settled with the new system. *Lack of team co-ordination due to the least understanding of the system. *Slow adoption of technology by the staff members. *Failure of technology resulting in shape of lost calls. Slow processing of the system. *Lack of backup system provision which is still not complete. As indicated in the PEST analysis the London Ambulance service used the cost differentiation strategy, which lead to severe losses due to the unpredictable and changing environment. "A cost leadership strategy is most effective in stable and predictable environments, since environments that are unpredictable or subject to much change, will create severe diseconomies for organisations trying to pursue a cost leadership strategy. Moreover, the many alterations needed to cope with a discontinuous environment would severely threaten a cost leader's efforts at efficiency and cost control." (Miller 1988) MOST ANALYSIS [B] Mission Objectives Strategies Tactics *The London Ambulance System charges scheme is aimed at providing hassle free and swift response. *To reduce the number of complaints by reducing the no. of errors while responding to the customer's needs. To attain higher response level to increase efficiency. *To cut delays. *To increase speeds. *To achieve a hassle free environment. To establish and maintain an well-organised and competent system by employing a body of capable expert staff. * To ensure that sufficient levels of staff are readily available to address issues of incorrect data processing. * To ensure that that the administration should have sufficient powers to be able to enforce the system. * To ensure the smooth running of the Systems. *To ensure the provision of latest technology *Ensuring system maintenance comprised of data transforming and recognition software. * To ensure support provision through the call centres * Ensuring that the public are kept fully in touch with additional information being added SWOT ANALYSIS [C] Strengths Weaknesses Opportunities Threats *Adoption of a usage of automated system in order to ensure timeliness and efficiency. * Saving the loss of lives due to the manual process of phone calls and data. storage *Help in improvement of LAS one of the largest service in the World. *Over expectations. *Impossible timeline *Ignorance of quality and emphasis on short timeline. *Quantitative guidance rather than Qualitative also. *Inadequate Policing to deal with the emergency situations or no contingency plans. *Future technology advancements could ensure a safer and more secure system. *The ability to be able to modify the system in order to sell a modified version to other countries. * Better planning and implementation while keeping in view all stakeholders could serve the purpose. *Change in the outsourcing trend can effect the efficient call centre service. * Failure to update the system according to the changing technology. * Inefficient use of funds. *The opposition of system from the employees. Objective: response to emergency calls and sustain response time, of reaching 75% of Category A (immediately life threatening) patient within 8 minutes. To achieve objective the following CSF and KPI have to be considered. CSF: The critical success factors are related to managers of different departments. Ambulance vehicle provision and maintenance manager should make sure the ambulance vehicles are running well by undertaking proper service check in order to keep the ambulances in ready to respond condition. They should also keep the ambulance fleet ready to use. Care should be taken about the condition of the vehicles and the vehicles with major mechanical problems should be replaced. Managers responsible for maintenance should undertake a frequent evaluation of the vehicles in order to ensure the efficient availability of the service The CSF for IS manager is to make sure the LASCADA system running at least 99.9% in a year hence the CSF about IS it works all the time. Also the CSF for IS system is the provision of back up system in case of any error or glitch in the proper working of the system. CSF for IT system is to ensure the updation of system with the technological advancement being taken place. CSF for IM system is that employees should know how to use the information system in order to improve their tasks performed. The lack of information about the data and improper storage can result in complications. So in order to use an Information System in a proper way, it is important that 1) Information related to the patient or caller should be properly stored and categorise in an understandable manner. 2) Data should be relevant and to the point. 3) The Information System should be user friendly. 4) It should enhance the performance of the drivers of locating the patients through using the data. KPI: "UK ambulance response to emergency calls: Current performance standards: Emergency ambulance services are required to meet national performance standards, with calls triaged in the ambulance control room as: Category A (immediately life threatening): 75% to be attended within 8 minutes. Category B (serious) and Category C (neither life threatening nor serious): 90% to be attended in 14 minutes (19 minutes in rural areas)." (Snooks et al., 2004) Reliability of LASCADA system is important, as it should be running 99.9% means the system down about half a day. ISIT assisting call center to collect accurate information and pass it to the ambulance driver via radio. Ambulance driver should be updated about traffic or road construction hence they would be able to take a short cut. Staff control sends ambulance to many different places in incident time however it has not been fast enough to get the patients. Perhaps they should locate ambulance station in middle of town. MIS & DSS: information can be collected about the ambulance in terms of how long and how far the ambulance response to emergence calls. Therefore the incidents locations can be looked at if there is ambulance station in these areas or not if there isn't then they should consider establishing one. However, establishing a new ambulance station can be quite expensive but this will help them to achieve their objectives this is an output from IS as collect information then exploiting it how to improve the service. Porters & Millers Generic framework: Competitive advantage over other services: -Focuses people in London -Only free London ambulance service which cover 600 sq. miles. -Get in right place at quick time -Competing against itself -The service has the most advanced and efficient ambulance provision system in the world. Cost: -Accurate system to stop duplicating same info to prevent sending more than one ambulance to same location. -Prevent writing down details of location this will save printing paper and save time and will reduce the cost by maximum avoiding the chance of error. -Despite the material advantage it will provide the most important benefit of saving the precious lives of people. IS strategy: The LASCADA system works effectively towards achieving the standard key performance indicators. The service is acquiring the most advanced technology available in order to respond effectively to the calls for the ambulance. The increasing in the volume of calls is increasing the pressure on the LAS to improve the service, which will not be possible with a slow system insufficient in answering calls. At the ambulance end, crews should be provided with the proper allocation data in order to improve the service. In order to respond to these needs the service has acquired technologies such as mobile phone tracking & Wi-Fi which help to download map so they get patient quickly. Wi-Fi system allows the crew to easily and efficiently locate the patient. Through the mobile phone they can get to patient fastly could be 6 to 8 mints. The system has improved the data transformation speed, which was approximately one minute to pass the call details to an ambulance crew by voice and then the crews. The crew now can locate the patient through navigation equipment. The details are sent in just two seconds to the ambulance. To accompany the Wi Fi system the department has now installed the latest Windows version of Mapinfo Professional. This system supplements the workload in the peak winter season when it is difficult to reach some of the hospitals the ambulance service has to divert admissions to other nearby hospitals. The GIS system enables the service to undertake most feasible and cost effective diversions, which are also time savvy. The system also helps in reducing the travel time of the staff by sending the nearest ambulance available in case of emergency. The Management Information Department of the London Ambulance service gathers information on the factors constituting the demand of the service in different areas. It is being realized that in the areas where the people own their cars the demand is relatively low as compare to the areas where people are poor and do not own private cars. The system is improving the performance by storing and providing the data, which quantify those factors. The system has enabled the service to handle approximately 2,000 calls; all of these calls are recorded in the MI database. The storage of the data helps the management to take decisions. The GIS has saved a lot of time by automating a lot of work done manually. Through t he uses of GIS, LAS can handle 250 ambulances on the streets of London at any one time, working from 68 ambulance stations. (London Ambulance Service GIS Experience, 1998) Conclusion: The implementation of Information system is an important task but its successful running is also crucial for a service like London Ambulance Service on which the lives of the people depends. Any gap in the performance of the system can lead to a loss of precious lives as experienced in past. Although none of the business or service organisation can implement a 100% fool proof system but the chance of error can be minimised by keeping in view important consideration while implementing and updating the Information system strategy. Chilcott (2001) presented a 7-Step Development Process in order to effectively under take an run an IS project: 1. Identify and List Stakeholders: The identification and listing of stakeholders is very important and the initial step in an IS project. The list of the stakeholders should include all the people who have the power to effect the system. The second category of stakeholders includes the people whose position and power will be affected by the project. The third and most important category is the users of the project. It is important to recognise the actual stakeholders of the project. The representatives of these stakeholders should be included in all the discussions related to the project in order to sketch the clear vision and necessities of project. After the identification process it is important to determine the problem statement. The entire stakeholder should reach an agreement on the definition of problem in order to design a project to fit the problem size for all the stakeholders. In case of LAS as experienced the political pressures to complete and implement LASCAD in a reduced time period ruined the performance of system. 2. Identify and List Actors The perceptions of the stakeholders regarding the project must be analysed or in other words it should be found that what all the stakeholders want from the project. The stakeholders can be divided into different groups according to their expectations regarding the project. The use and expectation of the stakeholders will help in designing the project in right way. It is seen in case of different projects that the developers and the involved stakeholders do not know about what they exactly want from the project. The development of an internal model regarding the perceptions of developers and stakeholders regarding the project will help all the people involved to expect, create, build and effectively use and support the system. The information needs of the crew and all the related staff should be kept on analysed and updated to increase the efficiency of the service. 3. Identify and List Use Cases Use cases are the core of the whole process. The use cases present the complete functionality of the system. A use case in defined as an interaction between the user and the system. The use cases of the different stakeholders differ according to their expectations. They are effective and meaningful tools to manage and organise the project. Recommendations: Although the 1992 LAS automation system was a failure but it is important for the LAS to plan the implementation of a CAD system. In order to plan and implement the new system it is important to take care of different aspects such as provision of back-up system, ownership concerns, completion of project within time scale while keeping in view quality, testing and training issues rather than earlier completion due to the political or Governmental pressures. With the technological matters human factors should also be kept in consideration. The staff should be treated as important stakeholder while designing the automation system. The training and awareness of staff should be given priority in order to make the employees use the system effectively. Control of project is also important on the designing and implementing stage, capable managers should be appointed to undertake these steps. On management level the important measures are commitment and appreciation of staff this will improve the success level of the system. The system should be eked with the necessary management, control, financial and man power factors required for the project at the right time. All these factors should be properly aligned with the step by step needs of the project. In order to keep the project working successfully the managers of the project should be answerable to a governing body, which should ensure the proper performance of the project and the support from the stakeholders. The specialists often observe the resistance that employees keep hidden from management and can also detect managers who are not putting their full weight behind projects. Information specialists should be trained to recognise and respond to resistance. These behavioural skills are just as important as technical skills. References CAD Failure LAS, (1992) available from http://www.lond.ambulance.freeuk.com/cad.html Chilcott, D., (2001). 7-Steps for building an Information System, Outformations, Inc., available from http://www.outformations.com/tools/SevenSteps.pdf Finkelstein, A., (1993). Report of the Inquiry into the London Ambulance Service: International Workshop on Software Specification and Design Case Study, available at London Ambulance Service GIS Experience, (1998). Geographical Information Systems: Case Studies. Business Computer World, February 1998, p.50-54, available from Miller, D., (1988). "Relating Porter's Business Strategies to Environment and Structure: Analysis and Performance Implications." Academy of Management Journal 31, no. 2: 280-308 H Snooks, N Kearsley, J Dale, M Halter, J Redhead and W Y Cheung, (2004). Towards primary care for non-serious 999 callers: results of a controlled study of "Treat and Refer" protocols for ambulance crews, Qual Saf Health Care, 2004; 13: 435-443, available from Read More