Ambulance Victoria Greg Leach & Grant Hocking Grampians Region RIPERN Forum 2013 Melbourne

AV Services Emergency medical response and pre-hospital care Emergency medical transport by road or air Non-emergency patient transport (including road and air stretcher transport and clinic transport for walking and wheelchair patients) Major incident management and response Retrieval of critically ill adult patients (including advice and bed coordination) Assistance for ambulance patients to access appropriate care when paramedic care or transport is not required Support for other health services in communities where the full range of services are not easily accessible Community education in pre-ambulance arrival emergency care The Ambulance Membership Scheme (ambulance insurance)

AV Rural

Regional Structure Administration Support Officer Regional Manager HR Partner Business Manager CSO Clinical Manager Group Manager Rostering OpCen TSO Fleet Maintenance 24 Hour Multi Officer Single Officer ACO CERT 24 Hour Multi Officer Single Officer ACO CERT OHS Partner Rehab Adviser CSO

Service Models Emergency road response (ALS and MICA Paramedic and Volunteer)Emergency road response (ALS and MICA Paramedic and Volunteer) Airwing (Fixed and rotary wing)Airwing (Fixed and rotary wing) Adult RetrievalAdult Retrieval Referral ServiceReferral Service Community and Firefighter First Responder ProgramsCommunity and Firefighter First Responder Programs Public Access DefibrillationPublic Access Defibrillation Non Emergency Patient TransportNon Emergency Patient Transport Emergency ManagementEmergency Management

Challenges Continued increased demand (approx 6% p.a.)Continued increased demand (approx 6% p.a.) Increased Hospital Transfer Times (Ramping)Increased Hospital Transfer Times (Ramping) Increasing number of low acuity cases (safety net)Increasing number of low acuity cases (safety net) Emergency / non-emergency balanceEmergency / non-emergency balance Changing workforce demographicChanging workforce demographic Active industrial environmentActive industrial environment

Demographic Challenges

Measuring our Success – Key Performance Indicators Dispatch TimesDispatch Times Response TimesResponse Times Customer satisfactionCustomer satisfaction Clinical PerformanceClinical Performance Cardiac Arrest outcomesCardiac Arrest outcomes Pain (Ischaemic and trauma)Pain (Ischaemic and trauma) (Adult and paediatric) TraumaTrauma StrokeStroke Resp distressResp distress PCR compliance to standardsPCR compliance to standards LOS (tPt, IFS, RSI, reattends, ARV, AAV Blood)LOS (tPt, IFS, RSI, reattends, ARV, AAV Blood) Open DisclosureOpen Disclosure

AV Strategic Plan Key Challenges Rising DemandRising Demand Performance ImpactPerformance Impact Health System ImpactHealth System Impact Meeting Community ExpecttaionsMeeting Community Expecttaions Engaging the AV WorkforceEngaging the AV Workforce Resourcing ConstraintsResourcing Constraints Financial FlexibilityFinancial Flexibility

AV Strategic Plan (continued) Strategic Priorities Coordinate and deliver safe and efficient patient-centred careCoordinate and deliver safe and efficient patient-centred care Work collaboratively to achieve a safe, capable, accountable and engaged workforceWork collaboratively to achieve a safe, capable, accountable and engaged workforce Partner with key stakeholders to deliver improved health outcomes, enhanced community safety and resiliencePartner with key stakeholders to deliver improved health outcomes, enhanced community safety and resilience Ensure AV’s business model can resource current service needs and investment in service improvementsEnsure AV’s business model can resource current service needs and investment in service improvements

Our Strategy Expanded Referral ServiceExpanded Referral Service Lower acuity emergency patients serviced through private providersLower acuity emergency patients serviced through private providers Multiple destinations for transported emergency patientsMultiple destinations for transported emergency patients

Call Referral Service Second tier medical triage systemSecond tier medical triage system Nurse based utilising specific softwareNurse based utilising specific software Directs non emergency 000 callers to more appropriate primary care servicesDirects non emergency 000 callers to more appropriate primary care services Provides over the phone self advice or referral to alternative service providers including locum medical services, mental health practitioners, nurses and outreach workersProvides over the phone self advice or referral to alternative service providers including locum medical services, mental health practitioners, nurses and outreach workers Deals with approximately 21,000 calls per annumDeals with approximately 21,000 calls per annum

Regional Partnerships AV and HS Memorandum’s Of UnderstandingAV and HS Memorandum’s Of Understanding Membership on RECCAC, GREC, Stroke and Cardiac WG’sMembership on RECCAC, GREC, Stroke and Cardiac WG’s Building better relationships at the local HS levelBuilding better relationships at the local HS level Regular AV/DH Liaison MeetingsRegular AV/DH Liaison Meetings Grampians Region Health Emergency Managers NetworkGrampians Region Health Emergency Managers Network Health Service CEO ForumsHealth Service CEO Forums Multi-Agency Training and ExercisingMulti-Agency Training and Exercising Supporting Nurse Education OpportunitiesSupporting Nurse Education Opportunities