St John initiatives in pre-hospital medical care

St John media release, 15 May 2008

St John initiatives in pre-hospital medical care

St John is involved in a number of initiatives and programmes designed to ensure the best possible care for patients while reducing unnecessary demand on hospital emergency departments and emergency ambulances, St John Operations Director Tony Blaber said today.

This is to help ensure that hospitals and ambulances have sufficient capacity to respond to emergencies, without reducing the level or standard of medical care provided to other patients.
One key initiative is the Acute Demand Coordination Service St John runs in Christchurch, designed to assist community practitioners administer certain care at home to patients who may otherwise have required an emergency ambulance response and presentation to an Emergency Department.  This service is funded by the Canterbury District Health Board (CDHB). Types of referrals to this service from GPs include:

Urgent diagnostics
IV therapy (e.g. for pneumonia)
Nurse assessments 
Urgent catheterisation.
 
The St John Acute Demand Coordination team includes a group of nurse coordinators, a senior administrator and service manager who have extensive and varied experience in practice, emergency and district nursing.  The service runs 7 days a week.  It also provides education and ongoing support to practices in the wider Canterbury area.  The coordination centre is co-located with the Christchurch Emergency Ambulance Communication Centre.

St John is evaluating opportunities to extend this service to patients who present through the emergency 111 service rather than their GPs and who could similarly be cared for at home rather than at hospital. Evidence that these models have a beneficial outcome will result in their likely adoption elsewhere in other parts of the country.  We are also seeking funding opportunities to further extend the role of ambulance officers so they can provide advanced assessment, care to patients in their own homes or referral to other agencies. 

Such initiatives are intended to ensure St John is providing a range of community services at the ‘top of the cliff’ – complementing our role as an emergency ambulance service provider where and when it is required for patients who have life threatened emergencies or require urgent clinical attention.

It is important to note that St John ambulance officers already treat many patients at home and at other accident or medical scenes, where medically appropriate.

When anyone rings 111 for ambulance, they are immediately connected to one of our three Emergency Ambulance Communications Centres from where emergency ambulances are dispatched based on medical priorities.  Trained call takers triage the calls – asking a series of structured clinical questions designed to determine the medical care required for the patient and the emergency response required.  If an ambulance or ambulances are required, they are dispatched while the call taker communicates any immediate first aid steps over the phone to the caller.  For instance, if a patient is in cardiac arrest, they need immediate CPR on the scene while an ambulance is being dispatched. 

On arrival at accident or medical emergency scenes, ambulance officers assess the patient, provide any necessary treatment at the scene and determine whether transport to a hospital or medical centre is required.

St John also has a close association with the national Healthline service – an 0800 number that members of the public can phone to get immediate medical advice 24/7 if they are unsure whether or not they need a doctor or ambulance.  Registered nurses provide advice, and can arrange an ambulance if required.

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