st john ambulance western australia data rich organisations: are we making the most of the...
TRANSCRIPT
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St John Ambulance Western Australia
Data Rich Organisations:Are we making the most of the information and engaging staff
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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 staff5. The Power of Simplicity
Data Rich Organisations:
Are we making the most of the information and engaging staff?
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St John Ambulance Western Australia
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St John Ambulance Western Australia
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St John Ambulance Western Australia
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St John Ambulance Western Australia
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St John Ambulance Western Australia
1962 to 2002 – “Convention”
2002 to 2013 – Incorporated Association
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St John Ambulance Western Australia
Sector OverviewPopulation:
»Australia 22.5m»New Zealand 4.0m»TOTAL 26.5m
Activity: Emergency 1.6m Urgent 0.9m Non-Urgent 1.2m TOTAL 3.7m NON-Transports 0.4m 11%
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St John Ambulance Western Australia
Sector Overview
Resusitation Emergency Urgent Semi-Urgent Non-Urgent0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Proportion of Patients Presenting at ED who arrived by ambulance – by triage category
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St John Ambulance Western Australia
Sector Overview
Government66%
User Fees25%
Subscription Fees5%
Other4%
Revenue = $2.2bn
Range of Government Funding = 37% to 91%
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St John Ambulance Western Australia
2003 2004 2005 2006 2007 2008 2009 2010 2011 20120%
1%
2%
3%
4%
5%
6%
7%
8%
Growth in Australian Ambulance Incidents
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
-2%
-1%
0%
1%
2%
3%
4%
5%
6%
7%
Growth in Australian Ambulance Incidents/1,000 Population
2012 Ambulance Incidents/1,000 Population
Australia 142Western Australia 96
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St John Ambulance Western Australia
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012-2%
0%
2%
4%
6%
8%
10%
12%
Growth in Western Australian Ambulance Incidents
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
-6%
-4%
-2%
0%
2%
4%
6%
8%
10%
Growth in Western Australian Ambulance In-cidents/1,000 Population
Growth over the decade:-Australia West Australia
Incidents 47% 59%Incidents/1,000 28% 26%
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St John Ambulance Western Australia
Key Facts – Western Australia
Population 2.3mLandmass 2.5m sq kmAmb. Incidents 230,000Staff Career(paid) 1,350 Volunteers 4,600First Aid Students 170,000Community First Responder Locations 410
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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 Activity92% paramedic 8% volunteer
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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
2. Deliver high quality cost effective ambulance services to Western Australia
7% of Population
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St John Ambulance Western Australia
Ambulance Service Cost per Capita
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St John Ambulance Western Australia
Ambulance Service Cost to Government per Capita
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St John Ambulance Western Australia
But, in 2009 ….
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St John Ambulance Western Australia
Ambulance Service Cost per CapitaAmbulance Service Cost to Government per Capita
Capital City 90th Percentile Response Times
What went wrong?
• Cost Effective ✓• Lowest cost to government ✓• Demand under control ✓• Response times reasonable ✓• Cardiac arrest survival good ✓
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St John Ambulance Western Australia
Data rich, performing well, but………
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St John Ambulance Western Australia
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St John Ambulance Western Australia
• “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:-
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St John Ambulance Western Australia
Data richEvidence basedGood results
but…….
Disconnected from staff
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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
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St John Ambulance Western Australia
WA ModelAmbulance
First Aid Training
First Aid Services
First Responder
Volunteers (Community
Engagement)
Strength
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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 + volunteer3. 1,500 to 2,000 – 24/7 paramedic + volunteer4. 250 to 1,500 - Community Paramedic5. < 250 – Full volunteer
2 7 52571
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St John Ambulance Western Australia
Volunteers
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St John Ambulance Western Australia
2012
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St John Ambulance Western Australia
2012
Challenges/Threats:
• Remain evidence based• Connection to staff
A
B
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St John Ambulance Western Australia
A
B
Challenges/Threats:
• Remain evidence based• Connection to staff
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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 developingresilient communities in this State. We will achieve our purpose when we:-
1. Make first aid a part of everyone’s life; and2. Deliver high quality cost effective ambulance services to Western
Australia
How do we connect our people to this purpose?
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St John Ambulance Western Australia
Know
Understand
Believe
Commit
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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 developingresilient communities in this State. We will achieve our purpose when we:-
1. Make first aid a part of everyone’s life; and2. Deliver high quality cost effective ambulance services to Western
Australia
SO HOW do we connect our people to this purpose?
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St John Ambulance Western Australia
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St John Ambulance Western Australia
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St John Ambulance Western Australia
Engagement with staff
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St John Ambulance Western Australia
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St John Ambulance Western Australia
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St John Ambulance Western Australia
Clinical Indicators:-
1.Chest Pain2.Asthma3.Hypoglycaemia4.Stroke5.Pain 6.Re-Perfusion Time7.Cardiac Arrest
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St John Ambulance Western Australia
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St John Ambulance Western Australia
Initiatives:-
1. Community paramedics – 242. Telephone triage – referral to Health Direct3. Referral to PRA – Silver Chain 4. Bridge House – Intoxicated patients5. 12 lead ECG6. A number of clinical trials
Evidence based models for extended care paramedics:-1. Evidence to identify pathways2. Phase 1 – identify cohorts3. Phase 2 – establish criteria (see & treat, see &
refer) and Test criteria – apply in field4. Phase 3 – Dynamic modeling5. Publish findings
Unique paramedic
degree program
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St John Ambulance Western Australia
Why this approach as opposed to the trialing of an extended care paramedic program?
Resusitation Emergency Urgent Semi-Urgent Non-Urgent0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Proportion of Patients Presenting at ED who arrived by ambulance – by triage category
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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; and2. Deliver high quality cost effective ambulance services to Western
Australia
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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”.
Resusitation Emergency Urgent Semi-Urgent Non-Urgent0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Proportion of Patients Presenting at ED who arrived by ambulance – by triage category
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St John Ambulance Western Australia
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St John Ambulance Western Australia
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St John Ambulance Western Australia
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St John Ambulance Western Australia
Questions?