Cutting empty runs: five levers from practice
From route bundling to planning the return as a pair: what well-run patient-transport operators do differently.
Every empty run is paid time with nothing to show for it: fuel, driver wages, vehicle wear — and the van is missing precisely when the next job comes in. In many transport operations, empty kilometres make up a noticeable share of the distance driven, and hardly anyone measures them. The good news: most of them are avoidable without hiring a single extra driver. Here are five levers that work in practice.
1. Actively couple return rides, don't leave them to chance
The classic case: a patient is driven to dialysis in the morning, the van returns empty, and at midday a second van sets off empty to pick up the same patient. If you plan outbound and return as a pair, you take half of the problem away.
The key is to think about the return ride at the moment the job is booked, not when the patient calls. Plan the return leg at the moment you create the outbound one.
2. Bundle routes geographically
Two rides to the same clinic, 20 minutes apart, by two different vehicles — that isn't an outlier, it's daily reality when nobody has an overview of the whole picture. A glance at the map instead of the individual jobs shows immediately which rides can be combined.
Rule of thumb: if two jobs lead to the same destination within 30 minutes and 5 kilometres, they belong in the same route — or there needs to be a very good reason against it.
3. Match the fleet to the prescription
The means of transport is on the prescription; the doctor chooses it by the medical necessity of the individual case (§ 4 Krankentransport-Richtlinie). Your lever is the fleet: an ambulance scheduled for a ride a taxi or hire car may drive is missing exactly when a Krankentransport comes in. If you align the vehicle class of every ride with the prescription, you keep the expensive vehicles free and incidentally reduce the idle time of the smaller ones.
4. Make idle time visible
Empty runs are only half the truth. The other half is idle time: the driver waits 40 minutes for a patient still in treatment. This time appears in no kilometre billing, yet it costs just as much. Only when driving and idle times are recorded per vehicle can you tell which van is driving and which one is mostly waiting.
5. Learn patterns from your own data
Transport operations are remarkably predictable. The same dialysis patients, the same time windows, the same clinics, week after week. Once you capture these patterns cleanly, you can plan routes in advance instead of reacting. This is where the biggest lever lies: most empty runs aren't caused by bad drivers, but by a lack of overview in dispatch.
What this means in numbers
How much these five levers bring depends on the operation, and we name no figure for it because we have measured none. What can be said: the effect does not come from expensive optimisation software but from seeing your own fleet in full.
The first step costs nothing: for one week, note every empty run and its reason. You'll be surprised how many of them trace back to two or three recurring patterns, and how well they can be stopped once they're visible.
Read on: what an empty run (Leerfahrt) is and dispatch in MitaBase.