1. St John Ambulance Western Australia Data Rich Organisations: Are we making the most of the information and engaging staff

2. St John Ambulance Western Australia Presentation:- 1. Share with you the St John Ambulance WA story. 2. Set the scene with a sector overview 3. Data rich – performing well, but….. 4. Investment in using data (evidence) and engaging with staff 5. The Power of Simplicity Data Rich Organisations: Are we making the most of the information and engaging staff?

3. St John Ambulance Western Australia

7. 1962 to 2002 – “Convention” 2002 to 2013 – Incorporated Association

8. St John Ambulance Western Australia Sector Overview Population: » Australia22.5m » New Zealand 4.0m » TOTAL26.5m Activity:  Emergency 1.6m  Urgent 0.9m  Non-Urgent 1.2m  TOTAL 3.7m  NON-Transports 0.4m 11%

9. St John Ambulance Western Australia Sector Overview Proportion of Patients Presenting at ED who arrived by ambulance – by triage category

10. St John Ambulance Western Australia Sector Overview Revenue = $2.2bn Range of Government Funding = 37% to 91%

11. St John Ambulance Western Australia 2012 Ambulance Incidents/1,000 Population Australia 142 Western Australia 96

12. St John Ambulance Western Australia Growth over the decade:- Australia West Australia Incidents 47% 59% Incidents/1,000 28% 26%

13. St John Ambulance Western Australia Key Facts – Western Australia Population 2.3m Landmass2.5m sq km Amb. Incidents230,000 Staff Career(paid) 1,350 Volunteers 4,600 First Aid Students170,000 Community First Responder Locations 410

14. St John Ambulance Western Australia Metropolitan Population 1.8m Career paramedics Single tier Emergency Patient Transport Service Rural Population 500,000 Career paramedics 14 locations Volunteers 150 locations Total Activity 92% paramedic 8% volunteer

15. St John Ambulance Western Australia Our Purpose Our purpose for being in Western Australia is for the unique contribution that we make in serving humanity and developing resilient communities in this State. We will achieve our purpose when we:- 1.Make first aid a part of everyone’s life; and 1.Deliver high quality cost effective ambulance services to Western Australia 7% of Population

16. St John Ambulance Western Australia Ambulance Service Cost per Capita

17. St John Ambulance Western Australia Ambulance Service Cost to Government per Capita

18. St John Ambulance Western Australia But, in 2009 ….

19. St John Ambulance Western Australia Ambulance Service Cost per Capita Ambulance Service Cost to Government per Capita Capital City 90 th Percentile Response Times What went wrong? Cost Effective ✓ Lowest cost to government ✓ Demand under control ✓ Response times reasonable ✓ Cardiac arrest survival good ✓

20. St John Ambulance Western Australia Data rich, performing well, but………

21. St John Ambulance Western Australia

22. “The national figures conclusively show that SJA has the most efficient ambulance service model in Australia and has saved this State substantial funds over the last century”. ”The figures show that Western Australian taxpayers per capita have paid about one quarter to a half that of tax payers in other states for the same level of service”, ”Indeed all of the indicators show that Western Australia is performing very highly in the comparative analysis”; ”Overall SJA is meeting its contractual requirements with DoH and in many areas is exceeding requirements”. Chairman of the Review Committee in his report to the Minister:-

23. St John Ambulance Western Australia Data rich Evidence based Good results but……. Disconnected from staff

24. St John Ambulance Western Australia 2009 to 2014 > 100% increase in Gov’t funding Doubling of the size of the organisation Metropolitan Capacity Country (rural) support

25. St John Ambulance Western Australia Ambulance First Aid Training First Aid Services First Responder Volunteers (Community Engagement)

26. St John Ambulance Western Australia Metropolitan: Single tier Paramedic Service Patient Transport Services Country: - 160 locations – 4 categories 1.> 3,000 cases – full paramedic 2.2,000 to 3,000 – day shift paramedic, night shift paramedic + volunteer 3.1,500 to 2,000 – 24/7 paramedic + volunteer 4.250 to 1,500 - Community Paramedic 5.< 250 – Full volunteer 2 7 5 25 71

27. St John Ambulance Western Australia Volunteers

28. St John Ambulance Western Australia 2012

29. St John Ambulance Western Australia 2012 Challenges/Threats: Remain evidence based Connection to staff A B

30. St John Ambulance Western Australia A B Challenges/Threats: Remain evidence based Connection to staff

31. St John Ambulance Western Australia Our Purpose Our purpose for being in Western Australia is for the unique contribution that we make in serving the community and developing resilient communities in this State. We will achieve our purpose when we:- 1.Make first aid a part of everyone’s life; and 2.Deliver high quality cost effective ambulance services to Western Australia How do we connect our people to this purpose?

32. St John Ambulance Western Australia Know Understand Believe Commit

33. St John Ambulance Western Australia Our Purpose Our purpose for being in Western Australia is for the unique contribution that we make in serving the community and developing resilient communities in this State. We will achieve our purpose when we:- 1.Make first aid a part of everyone’s life; and 2.Deliver high quality cost effective ambulance services to Western Australia SO HOW do we connect our people to this purpose?

34. St John Ambulance Western Australia

36. Engagement with staff

37. St John Ambulance Western Australia

39. Clinical Indicators:- 1.Chest Pain 2.Asthma 3.Hypoglycaemia 4.Stroke 5.Pain 6.Re-Perfusion Time 7.Cardiac Arrest

40. St John Ambulance Western Australia

41. Initiatives:- 1.Community paramedics – 24 2.Telephone triage – referral to Health Direct 3.Referral to PRA – Silver Chain 4.Bridge House – Intoxicated patients 5.12 lead ECG 6.A number of clinical trials Evidence based models for extended care paramedics:- 1.Evidence to identify pathways 2.Phase 1 – identify cohorts 3.Phase 2 – establish criteria (see & treat, see & refer) and Test criteria – apply in field 4.Phase 3 – Dynamic modeling 5.Publish findings Unique paramedic degree program

42. St John Ambulance Western Australia Why this approach as opposed to the trialing of an extended care paramedic program? Proportion of Patients Presenting at ED who arrived by ambulance – by triage category

43. St John Ambulance Western Australia “Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat. Sun Tzu We will achieve our purpose when we:- 1.Make first aid a part of everyone’s life; and 2.Deliver high quality cost effective ambulance services to Western Australia

44. St John Ambulance Western Australia Why this approach as opposed to the trialing of an extended care paramedic program? – It really depends on the “purpose”. Proportion of Patients Presenting at ED who arrived by ambulance – by triage category

45. St John Ambulance Western Australia

48. Questions?