How St John returns 1000 hours of emergency ambulance service to community every month

How St John returns 1000 hours of emergency ambulance service to community every month

• St John returns about 1000 hours of emergency ambulance response to community response every month through strategies to reduce ambulance ramping,
• Ramping impacts response times once it hits an average of 50 hours per day, or about 1500 hours per month,
• St John remains the only Australian ambulance service to publicly report daily updates of ambulance ramping figures.

About 1000 hours of emergency ambulance response are returned to community every month as part of St John WA’s strategies to address ambulance ramping.

St John WA Executive Director of Ambulance Deon Brink said monthly ramping figures had reduced since August 2021 which recorded more than 6000 hours, however rates remained very high.

“Health services across Australia are under pressure and WA is no different. We expect ambulance ramping will continue as we hit the winter flu season and pressure related to COVID-19. We are doing everything we can to free capacity and support patients waiting for transfer to hospital care.”

“Last year ambulance ramping equated to removing about 4.5 ambulances from the road every day. We know any amount of ambulance ramping over 50 hours per day will impact our ability to respond to Triple Zero (000) calls as our crews are tied up waiting at hospitals to transfer patients. We will continue working with our partners across the health system to address this issue.”

Latest initiatives included:

• Adding more than 260 additional frontline personnel since mid-2020 to date, and additional 233 frontline positions will be appointed during 2022,
• Appointing Hospital Liaison Mangers to fast-track patient handover in EDs and support frontline staff,
• Multi-patient Takeovers during which one crew takes over care of a second patient while waiting at an Emergency Department, delivering 1-to-1 care to patients and freeing up a crew to respond to Triple Zero (000) calls,
• Allowing a transported patient, who is able and safe, to wait in ED prior to transfer of care while the crew turns to operations,
• Continuing a Secondary Triage Team to deliver suitable patients to alternative care pathways,
• Facilitating triage en-route for ED bypass through a Virtual Emergency Medicine program,
• Introducing a Patient Transport Paramedic trial for Priority 4 inter-hospital transfers.

St John WA is the only Australian ambulance service which publishes daily ambulance ramping and performance figures to keep patients and the community informed.

What is ambulance ramping?

The Australasian College for Emergency Medicine observes in its Position Statement on Ambulance Ramping that:

“In a well-functioning system, with good access to cubicles and beds, the time interval of ambulance arrival to clinical handover should routinely occur within 15 minutes and never take more than 30 minutes.”

Technically known as “Extended Transfer of Care” a new definition of the practice was agreed in in 2020 to reflect the potential 30-minute timeframe for patients to be transferred from the care of St John to that of the hospital.

Reducing pressure on emergency ambulance

Our The First Responder Program includes:

• The Community First Responder Network which is more than 6000 locations across WA with a registered publicly-accessible Automated Electronic Defibrillator which can be accessed by calling Triple Zero (000).
• The First Responder App which connects 33,000 First Aid trained first responders to the State Operations Centre who can be called upon in event of an emergency in public to render support.

This means members of the public can be called upon by the State Operations Centre to respond in an emergency in the precious first few minutes before an ambulance arrives.

Reducing pressure on emergency departments

St John has a network of five Urgent Care clinics which offer an alternative to busy Emergency Departments for patients with urgent – but not emergency – care needs.

The centres are supported by a $28 million Federal Government investment which will explore the impact they make on the health system.

The Urgent Care model has been designed to divert unnecessary visits to ED which account for more than half of all visits by WA would-be patients to hospital. Research shows about 16 out of the 20 most common ED presentations can be safely managed in a non-emergency department setting. These are often “walk ins”, separate from emergency ambulance presentations.