The employment of 158 additional frontline staff, improved technology in ambulances including updated mapping software, new deployment plans, and innovative approaches to providing the right care for non-urgent 111 cases contributed to record response time performance for the St John emergency ambulance service.
The St John National Annual Report for the year ended 30 June 2015 shows St John ambulances responded to patients with life-threatening conditions more quickly than ever before – despite answering 17,020 more 111 calls than in the previous year.
St John provides emergency ambulance services to nearly 90% of New Zealanders in 97% of New Zealand’s geographical area.
St John also reported growth in programmes designed to build community resilience and improve the health and wellbeing of New Zealanders. Highlights include an 11% increase in the number of people trained in first aid training, and a 31% increase in the number of children who learned to respond confidently in an emergency situation through the St John in Schools programme.
St John was voted Most Trusted Charity in the 2015 Reader’s Digest Trusted Brand Awards.
St John Chief Executive Officer, Peter Bradley said the achievements of the 2014/15 year are a testament to the commitment of St John people to continuously improve the quality and safety of patient care, the generosity of the individuals and organisations that support St John, and the organisation’s strong partnerships within the health and emergency sectors.
I am very proud of what we have achieved over the past year,” Mr Bradley says. “Through the efforts of all our paid and volunteer staff we have delivered a quality ambulance service to New Zealanders, and made a positive impact in communities throughout the country.
“We invested in core infrastructure, the innovative 111 Clinical Hub and ePRF projects, which are designed to improve patient outcomes, and the operational expenditure of our extra frontline staff. These improved performance figures represent a significant return on investment for St John, for our strategic partners the Ministry of Health (MoH) and the Accident Compensation Corporation (ACC), who supported these important initiatives, and the many New Zealanders who support us.”
The 2014/15 year saw St John complete development of one of the most significant projects in the organisation’s history, the electronic Patient Report Form (ePRF), which replaces paper patient records with electronic versions written on handheld Samsung tablets. The world-leading technology allows the secure transmission of patient information between ambulances and hospital emergency departments.
St John reported an underlying deficit of $7.5 million for the 2014/15 financial year. Revenue increased by 6.1% to $256.7 million and operating expenditure increased by 11.6% to $266.4 million, compared with the previous year. The shortfall represents the investment of reserves generated in previous years to improve service delivery, and manage increasing demand. In 2014/15 St John answered 454,990 111 emergency ambulance calls, up 3.9% year-on-year.
“St John strives to provide the best possible service to New Zealanders, despite increasing demand and resource constraints. We have achieved great success in the past year and will continue to do the right thing for our patients and our people,” says Mr Bradley.
“We could not achieve this without the generosity of New Zealanders, from our key corporate partner ASB Bank to the 75,000 individual donors who contributed to our work during the past year. We never take the trust and support of the community for granted.”
In addition to improving response times, the additional 158 ambulance staff enabled St John to reduce the number of incidents attended by a single-crewed ambulance by 10,000, improving patient and staff safety. Achieving support to deliver 100% safe crewing is a major focus of St John’s five-year workforce plan.
Mr Bradley says: “Despite these improvements, there are many thousands of times each year St John emergency ambulances are sent to incidents with a single crew member, and this is something we are committed to bringing to an end as soon as possible. We are seeking support from the Government to help with this.”
A Government-commissioned independent review of ambulance funding is underway to help inform future funding arrangements. St John currently has contracts with MoH, ACC and District Health Boards who fund approximately 70% of the operating costs of the ambulance service. The remaining 30% is paid for through fundraising, revenue from commercial activities such as first aid training and medical alarms, and emergency ambulance part charges. St John’s fundraising and commercial activities also support the organisation’s charitable community programmes.
-ENDS-
FOR FURTHER INFORMATION CONTACT:
Rachel Lorimer
St John Head of Communications
T 09 526 0528 I X 8095 I F 09 526 0553 | M 021 436 503 | E rachel.lorimer@stjohn.org.nz
Victoria Hawkins
St John Media & Public Relations Manager
T 09 526 0528 I X 7877 I F 09 526 0553 | M 021 605 342 | Evictoria.hawkins@stjohn.org.nz
NOTE TO EDITORS
St John by the numbers – 2014/15
19,693,430 Kilometres travelled by ambulances
454,990 111 emergency calls for an ambulance
428,319 Patients treated and/or transported by ambulance officers
80,000 Downloads of St John’s free CPR App
73,118 People trained in first aid
49,101 Children participated in the St John in Schools programme
9,447 Volunteers
7,646 Youth members
2,090 Paid personnel
662 Ambulances and operational vehicles
201 Ambulance stations
96% of ambulance patients have high or very high trust and confidence in St John
95% of 111 calls answered within 15 seconds
Improvement in emergency response times
St John has performance targets for three types of incidents agreed with the Ministry of Health and the Accident Compensation Corporation,
- immediately life-threatening (‘Purple’)
- immediately life-threatening or time-critical (‘Red’)
- urgent or potentially serious but not immediately life-threatening (‘Orange’).
Response times to Purple and Red incidents (when every second counts) are the key performance measures for an ambulance service. In 2014/15, St John achieved its best performance to date:
- The response target for Purple and Red incidents in urban areas is 50% within 8 minutes. In 2014/15 St John reached 56.5% within 8 minutes, up +5.2%.
- In rural areas the Purple and Red response target is 50% within 12 minutes. In 2014/15 St John reached 52.3% within 12 minutes, an improvement of +2.3%
Key contributing factors were an increase in frontline staff, the implementation of new deployment plans, the impact of the 111 Clinical Hub and other initiatives in our Clinical Control Centres, our partnership with the NZ Fire Service, and technological improvements.
Electronic Patient Report Forms
This year saw St John reach a major milestone, completing the development and testing of the electronic Patient Report Form (ePRF). This world-leading technology replaces handwritten, paper-based ambulance patient record forms with an electronic version written on handheld Samsung tablets. The electronic record integrates with the District Health Board (DHB) system, so patient-receiving points such as ED or Maternity can access real time information from incoming ambulances, improving the quality and safety of patient care. There are many opportunities for future integration with other healthcare providers.
St John, supported by the Ministry of Health and ACC, led the ePRF project for the New Zealand ambulance sector, working closely with colleagues across the health sector to implement this important initiative. A successful five-week pilot was carried out in the Auckland and Canterbury regions in August and September 2015, and nationwide implementation began on 14 October. St John ambulance crews and DHB staff have embraced the new technology and the value it adds to our service.
The 111 Clinical Hub
One of the most significant achievements of the past year was the successful pilot of the 111 Clinical Hub in the Auckland region. The Clinical Hub is a secondary triage process designed to safely and effectively help patients who do not need to be transported to an emergency department – providing these patients with the right care at the right time, and freeing up emergency ambulance and hospital resources to treat more urgent cases.
An independent external review on the Clinical Hub was undertaken by the Sapere Research Group, who reported; “The Clinical Hub provides a valuable tool for undertaking secondary triaging of less urgent 111 calls. There is strong evidence that it represents a material improvement on the status quo and there is likely to be a compelling case for expanding the Clinical Hub to a national footprint.”
The Clinical Hub had a significant impact on the number of ambulance presentations to Emergency Departments in the Auckland DHB reducing them by 6,000 during the year of the pilot. Key to the success of the trial was St John’s partnership with Homecare Medical, whose registered nurses work in our 111 Clinical Control Centres.
St John in Schools
This year saw a major expansion of St John in Schools with 49,101 children taking part in the 2014/15 year, a 31% increase year-on-year. St John in Schools develops the confidence and capability of preschool and school-aged children, teaching them how to respond in an emergency environment.
Our tutors teach different skills to different age groups, offering four modules; Responding in an Emergency, Camping, Disaster Preparedness, and Accident Prevention and Injury Care. Supported by a partnership with ACC, St John in Schools will expand significantly in the coming year. Over time, our goal is to reach 480,000 students from preschool through to Year 7, improving the emergency preparedness and general resilience of the next generation.