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

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

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

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

8. Sector Overview Population: • 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%

9. Sector Overview Proportion of Patients Presenting at ED who arrived by ambulance – by triage category

10. Sector Overview Revenue = $2.2bn Range of Government Funding = 37% to 91%

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

12. Growth over the decade:- AustraliaWest Australia Incidents 47% 59% Incidents/1,000 28% 26%

13. Key Facts – Western Australia Population 2.3m Landmass 2.5m sq km Amb. Incidents 230,000 Staff Career(paid) 1,350 Volunteers 4,600 First Aid Students 170,000 Community First Responder Locations 410

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

15. 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:- • Make first aid a part of everyone’s life; and • Deliver high quality cost effective ambulance services to Western Australia 7% of Population

16. Ambulance Service Cost per Capita

17. Ambulance Service Cost to Government per Capita

18. But, in 2009 ….

19. Ambulance Service Cost per Capita Ambulance 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 ✓

20. Data rich, performing well, but………

22. Chairman of the Review Committee • in his report to the Minister:- • “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”.

23. Data rich Evidence based Good results but……. Disconnected from staff

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

25. WA Model Strength

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

27. Volunteers

28. 2012

29. A • Challenges/Threats: • Remain evidence based • Connection to staff 2012 B

30. A • Challenges/Threats: • Remain evidence based • Connection to staff B

31. 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:- Make first aid a part of everyone’s life; and Deliver high quality cost effective ambulance services to Western Australia How do we connect our people to this purpose?

32. Know Understand Believe Commit

33. 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:- Make first aid a part of everyone’s life; and Deliver high quality cost effective ambulance services to Western Australia SO HOW do we connect our people to this purpose?

36. Engagement with staff

39. Clinical Indicators:- Chest Pain Asthma Hypoglycaemia Stroke Pain Re-Perfusion Time Cardiac Arrest

41. Initiatives:- Community paramedics – 24 Telephone triage – referral to Health Direct Referral to PRA – Silver Chain Bridge House – Intoxicated patients 12 lead ECG A number of clinical trials Unique paramedic degree program Evidence based models for extended care paramedics:- Evidence to identify pathways Phase 1 – identify cohorts Phase 2 – establish criteria (see & treat, see & refer) and Test criteria – apply in field Phase 3 – Dynamic modeling Publish findings

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

44. 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

48. Questions?