St John Ambulance Western Australia

Data Rich Organisations:Are we making the most of the information and engaging staff

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?

St John Ambulance Western Australia

St John Ambulance Western Australia

St John Ambulance Western Australia

St John Ambulance Western Australia

St John Ambulance Western Australia

1962 to 2002 – “Convention”

2002 to 2013 – Incorporated Association

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%

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

St John Ambulance Western Australia

Sector Overview

Government66%

User Fees25%

Subscription Fees5%

Other4%

Revenue = $2.2bn

Range of Government Funding = 37% to 91%

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

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%

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

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

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

St John Ambulance Western Australia

Ambulance Service Cost per Capita

St John Ambulance Western Australia

Ambulance Service Cost to Government per Capita

St John Ambulance Western Australia

But, in 2009 ….

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 ✓

St John Ambulance Western Australia

Data rich, performing well, but………

St John Ambulance Western Australia

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:-

St John Ambulance Western Australia

Data richEvidence basedGood results

but…….

Disconnected from staff

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

St John Ambulance Western Australia

WA ModelAmbulance

First Aid Training

First Aid Services

First Responder

Volunteers (Community

Engagement)

Strength

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

St John Ambulance Western Australia

Volunteers

St John Ambulance Western Australia

2012

St John Ambulance Western Australia

2012

Challenges/Threats:

• Remain evidence based• Connection to staff

A

B

St John Ambulance Western Australia

A

B

Challenges/Threats:

• Remain evidence based• Connection to staff

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?

St John Ambulance Western Australia

Know

Understand

Believe

Commit

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?

St John Ambulance Western Australia

St John Ambulance Western Australia

St John Ambulance Western Australia

Engagement with staff

St John Ambulance Western Australia

St John Ambulance Western Australia

St John Ambulance Western Australia

Clinical Indicators:-

1.Chest Pain2.Asthma3.Hypoglycaemia4.Stroke5.Pain 6.Re-Perfusion Time7.Cardiac Arrest

St John Ambulance Western Australia

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

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

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

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

St John Ambulance Western Australia

St John Ambulance Western Australia

St John Ambulance Western Australia

St John Ambulance Western Australia

Questions?