M_Hooper.ppt
Transcript of M_Hooper.ppt
Statewide SA Retrieval Service
Looking back. Moving forward.
November 2008
Outline
• Background
• Change
• Where we are heading: Governance and leadership Retrieval Coordination Workforce Operations Training Clinical Governance Time lines
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
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
Change…………
‘It is not the strongest of the species that
survive, nor the most intelligent, but the one
most responsive to change’
Charles Darwin
The wind’s of change……….
“The pessimist complains about the wind and builds walls.
The optimist expects it to cease……..one day.
The realist……….builds windmills”
The momentum of change
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……..
Core components – SA Retrieval
Retrieval Coordination (Retrieval and transport)
PNPR*Adult Retrieval &Rapid Response
*PNPR = Paediatric, neonatal and perinatal retrieval
GovernanceMinister for Health
SA Health
CNAHS
‘SA Retrieval’ (Name TBC)
Retrieval Clinical Coordination
Adult Retrieval & Rapid Response
Paediatric, Neonatal and Perinatal Retrieval
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
Retrieval Coordination
> One centre
> One number (+ ‘000’)
> Co-located with SAAS
> Retrieval and transport
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 (Victorian
Ambulance Clinical Inform. System)
> Clinical Governance and audit
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
National Comparisons – Adult Retrieval
STATE TEAM COMPOSITION
NSW
(non-regional)
R: Doctor & SCAT Paramedic
H: Doctor & SCAT Paramedic
F: Doctor & Flight Nurse
Queensland
(major centres)
R: Doctor & IC Paramedic
H: Doctor & IC Paramedic
F: Doctor & RFDS Flight Nurse
Victoria R:MICA Paramedic +/- Doctor
H:MICA Paramedic +/- Doctor
F:MICA Paramedic +/- Doctor
ACT
R: Paramedic + Doctor
H: Paramedic + Doctor
F: N/A
Tasmania
R: N/A
H: Paramedic
F: Doctor & Paramedic
WA
R: N/A
H: Paramedic +/- Doctor
F: Doctor + RFDS Flight Nurse
Northern Territory
R: N/A
H: N/A
F: Doctor + Flight Nurse
South Australia
R: Doctor + Retrieval Nurse
H: Doctor, Retrieval Nurse (IHT) and Paramedic (1°)
F: Doctor, Retrieval Nurse and RFDS Flight Nurse
Adult team flexibilityAcross platforms. Across tasks
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
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
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
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
Timelines
July 2008 (Governance and leadership)
January 2009 (Service models)
January 2010 (Implementation)
Stage 1
Stage 2
Stage 3
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
My commitment
> To deliver a…• safe
• rapidly responsive
• innovative
• sustainable
• efficient
• effective
• leading
• patient focussed
• outcome driven
> service for the SA Health Care region
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.”