A capacity sharing approach to manage jointly transportation and emergency fleets at EMS organisations

Emergency Medical Services (EMS) first mission is to reach people requiring urgent medical attention and transport them to hospitals or care facilities. In many cases, EMS also provide a second mission, which concerns the non-emergency transportation of patients. These services have different characteristics and goals from a managerial standpoint and in practice, most EMS organisations split their fleet into two sub-fleets that are managed independently. However, both missions are in most of the cases carried out by the same types of ambulances and crews, suggesting that managing both fleets together might bring potential advantages. This study explores the potential advantages of a new management strategy that allows sharing resources between two separated ambulance fleets. In particular, the proposed strategy allows for dynamically modifying the size of each fleet considering that a subset of ambulances can change their mission during the day to better adapt to the system's state. This strategy offers an incomplete integration of the fleets, but has the worthy advantages of improving the overall system performance and being simple to implement by an EMS organisation. Numerical experiments on realistic instances demonstrate, using a discrete event simulation tool, the feasibility and benefits of the proposed strategy.