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Transcript

  • 1. Statewide SA Retrieval Service Looking back. Moving forward. November 2008
  • 2. Outline
      • Background
      • Change
      • Where we are heading:
        • Governance and leadership
        • Retrieval Coordination
        • Workforce
        • Operations
        • Training
        • Clinical Governance
        • Time lines
  • 3. Background
    • A few drivers of change
      • Risks
      • Coronial recommendations
      • Workforce dynamics
      • Costs (Financial & other. Overt and hidden)
      • Inefficiency, duplication and disintegration
      • Benchmark comparisons
      • Increasingly complex environments
      • Service demand & future challenges
  • 4. Progress
    • Portfolio Executive -12/06
    • Director commences -10/07
    • Movement to Operations Division -12/07
    • Strategy formation (SCAG)
    • Workshop -12/07
    • Discussion paper -2/08
    • Project plan development
    • Road show and stakeholder consultation (ongoing)
    • Feedback review - 5/08
    • International visits 5/08
    • Workshop 2 - 6/08
    • Movement to CNAHS – 7/08
    • Governance & leadership
    • Re-defining model (ongoing)
    • Implementation
  • 5. Change…………
    • ‘ It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change’
    • Charles Darwin
  • 6. The wind’s of change……….
  • 7. “ The pessimist complains about the wind and builds walls. The optimist expects it to cease…….. one day. The realist………. builds windmills”
  • 8. The momentum of change
  • 9. Change……….
    • There will be a single Statewide Retrieval Service for SA.
    • This will not be one of or a federation of existing services.
    • Current service delivery strengths will be extended.
    • We will develop a service for the present but most importantly for the future
    • There will be three core components to the new service……..
  • 10. Core components – SA Retrieval *PNPR = Paediatric, neonatal and perinatal retrieval Retrieval Coordination (Retrieval and transport) PNPR* Adult Retrieval & Rapid Response
  • 11. Governance Minister for Health SA Health CNAHS ‘ SA Retrieval’ (Name TBC) Retrieval Clinical Coordination Adult Retrieval & Rapid Response Paediatric, Neonatal and Perinatal Retrieval
  • 12.  
  • 13. Leadership
    • Director, Statewide SA Retrieval Services
      • Increasingly operational
    • Clinical Directors
      • Retrieval Coordination
      • Training and Standards
      • Paediatric & Neonatal Retrieval
    • Nursing
      • Director (L5)
      • Operational/Management (L4)
    • Paramedical
      • Team leader
    • Project & administrative team
      • ASO 3 and 6
  • 14. Retrieval Coordination
    • One centre
    • One number (+ ‘000’)
    • Co-located with SAAS
    • Retrieval and transport
  • 15. Retrieval Coordination
    • Multi-agency coordination:
      • Health (Medical and SAAS) and RFDS
    • Best practice models:
      • National
      • International
      • Clinical network integration
    • Innovative ideas:
      • Workforce (Critical Care Nursing)
      • Process
      • IT and technology
        • Asset tracking
        • Teleconference
        • Telemedicine and video streaming
        • Tasking & CAD systems
        • Point of care data entry ( V ictorian A mbulance C linical I nform. S ystem)
    • Clinical Governance and audit
  • 16. Workforce
    • The right people (skills, knowledge and attitude )
    • Retrieval team:
      • Familiarity
        • Each other
        • Equipment
        • Environment
          • Clinical
          • Other
      • Safety
        • Team
        • Patient
      • Flexibility
        • Across tasks
        • Across platforms
      • Redundancy
      • Efficiency and effectiveness
      • Avoidance of a ‘split system’ within adult service
  • 17. National Comparisons – Adult Retrieval R: Doctor + Retrieval Nurse H: Doctor, Retrieval Nurse (IHT) and Paramedic (1°) F: Doctor, Retrieval Nurse and RFDS Flight Nurse South Australia R: N/A H: N/A F: Doctor + Flight Nurse Northern Territory R: N/A H: Paramedic +/- Doctor F: Doctor + RFDS Flight Nurse WA R: N/A H: Paramedic F: Doctor & Paramedic Tasmania R: Paramedic + Doctor H: Paramedic + Doctor F: N/A ACT R:MICA Paramedic +/- Doctor H:MICA Paramedic +/- Doctor F:MICA Paramedic +/- Doctor Victoria R: Doctor & IC Paramedic H: Doctor & IC Paramedic F: Doctor & RFDS Flight Nurse Queensland (major centres) R: Doctor & SCAT Paramedic H: Doctor & SCAT Paramedic F: Doctor & Flight Nurse NSW (non-regional) TEAM COMPOSITION STATE
  • 18. Adult team flexibility
      • Across platforms. Across tasks
  • 19. Workforce
    • Adult & RR (team of 2)
      • Medical
        • Consultants
        • Fellows
        • Registrars
      • Paramedic/Nursing
        • Dual qualification?
        • ‘ Practitioner’ level
    • N&P (team of 2)
      • Medical
        • Consultants
        • Fellows
        • Registrars
      • Nursing
        • ‘ Practitioner’ level
        • Neonatal & Paediatric
    Relatively small groups performing complicated tasks frequently
  • 20. Operations
    • Dedicated service capacity
      • Adult ( up to 3 teams)
      • Neonatal & Paediatric (1 team)
    • Operational base issues
      • Interim
        • Old CHC base
      • Long term
        • Joint Emergency Services?
        • Assistance?
    • Improve:
      • Rapid Response capacity
      • Team development/CRM
      • ‘ Empty leg’ helicopter costs
      • Service identity
    • Allow:
      • Service expansion
  • 21. Training
    • Post-graduate educational opportunities
      • Supported
      • Aiding recruitment and retention
    • Harness in-house resources
      • Personnel, other agencies, experience…..
    • Links with developing National programs
      • JCU
    • Actively encourage Research
    • Actively encourage innovation
    • Standardise safety training
    • College re-accreditation
  • 22. Clinical Governance
    • ‘ A culture of safety’
      • Open, multi-agency and qualitative processes
    • Continuous service enhancement
      • Closed loop processes
      • Links with ongoing training
      • Relevant KPI measures
    • Supported training
      • TeamSTEPPS
      • CPI program
      • TRM course
    • Alignment with State, National and International quality and safety frameworks
      • AIMS
  • 23. Timelines
    • July 2008 (Governance and leadership)
    • January 2009 (Service models)
    • January 2010 (Implementation)
    Stage 1 Stage 2 Stage 3
  • 24. Rural workforce support/engagement
    • Coordination
      • Point of contact
      • Advice, transport and/or retrieval
      • Network integration
    • Response
      • Time
      • Standardisation
    • Training opportunities
    • Clinical Governance and audit
      • Feedback
      • Q&S
      • Research
  • 25. My commitment
    • To deliver a…
      • safe
      • rapidly responsive
      • innovative
      • sustainable
      • efficient
      • effective
      • leading
      • patient focussed
      • outcome driven
    • service for the SA Health Care region
  • 26. Where we are heading……..
    • “ Leaders who inspire realise there will always be rocks in the road ahead of us.
    • They will be stumbling blocks or stepping stones; it all depends on how we use them.”