Transcript Slide 1

EMERGENCY CARE
CO-ORDINATION TEAMS
(ECCT)
CANTERBURY / WEST COAST AND OTAGO /
SOUTHLAND
SOUTH ISLAND DHB CEO MEETING
22 AUGUST 2008
PRESENTATION OVERVIEW
• Background to ECCT’s
• Who we are and what we’ve achieved:
- Canterbury / West Coast ECCT
- Otago / Southland ECCT
• Ongoing and Future linkages within
DHB’s
OVERVIEW
1999 - release of “Roadside to Bedside”
a 24 hour Clinically Integrated Acute Management
System for NZ
joint publication through MoH, ACC, HFA and Council of
Medical Colleges in NZ
aimed to ensure the best outcomes for patients involved in
trauma, medical and surgical emergencies and
complicated births
KEY AIMS
“people get the right care,
at the right time,
in the right place
from the right person”
ESTABLISHMENT OF ECCT’s
Jointly funded by ACC and MoH (devolved to DHB’s)
KEY ROLES:
• to enhance regional co-ordination of all emergency care
providers
• advise regional service providers and funders ACC/MoH/DHB’s)
on issues relating to provision, distribution and standard of
emergency acute health services
• scope is across continuum from pre-hospital to specialist service
delivery
OPERATION OF ECCT
RESEARCH / SOLUTION
PROPOSAL
ISSUE / PROBLEM
ECCT forum
Advice to and
reporting to
Reporting to
MINISTRY OF HEALTH
and ACC
Direct
question
facilitates, connects
and establishes
working groups
Advice to, and
recommendations between
both groups
DHB’s, Ambulance Services, other
providers, interested parties
AIMS OF ECCT
INTEGRATED AND EFFECTIVE REGIONAL EMERGENCY CARE SYSTEM
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Implement recommendations of Roadside to Bedside
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Overall systems design
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Integrated communications network
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Common standards and protocols
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Integrated provision of all key system components
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Team approach to development and operation of all system aspects
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Improved information systems to allow sound performance monitoring and
continuous improvement
NATIONALLY
ECCT’S CURRENTLY OPERATIONAL IN:
Otago / Southland
Canterbury / West Coast
Midland (central North Island)
IN RECESS:
Central Region (Lower North / Upper South Island)
UNDER DISCUSSION:
Northland
Auckland
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CHAIRPERSONS AND CO-ORDINATORS
meet bi annually with MoH, ACC and other key parties in Wellington
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COMMUNICATIONS USER GROUPS and regional PRIME committees
have reporting lines back to ECCT for oversight.
“UNIQUENESS OF ECCT”
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Very wide member representation across all aspects of pre - hospital
emergency care: not replicated in the sector
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Unique opportunity to have this combined skill and knowledge base around
the table.
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Based on respect and collaboration to see sector working seamlessly
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A solution finding / problem solving and pre-emptive forum for
emergency health care issues
SECTOR LINKAGES
EXTERNAL NATIONAL REPRESENTATION
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Air Ambulance Review Group
National Trauma Database
Interhospital Transfer Working Group
PRIME reviews and development
National Framework of Ambulance Delivery, Retrieval and Transfer
DOCUMENT REVIEWS / CONTRIBUTIONS
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Ambulance Services Sector Standards review
Interhospital Transfer review
Ashburton Model of Care (C/W ECCT)
Parliamentary Health Select Committee Review into provision of Ambulance Services in NZ (C/W
ECCT)
LINKED INVOLVEMENT
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Integrated Model of Care for Ashburton Health Services (C/W ECCT)
Improving the Patient Journey Project, Christchurch Hospital (C/W ECCT)
DHBNZ Inter Hospital Air Ambulance group
Acute Demand and Emergency Care Practitioners Project (ED - CDHB)
CANTERBURY WEST COAST
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Inception 2002
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Co-ordinator appointed 2005 (0.5FTE)
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Original contract with St John; moved to CDHB since April 2008 after 6 month recess
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Strong and active ongoing membership from CDHB, SCDHB, WCDHB
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Linkage with NMDHB re boundary issues
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Linkages nationally with other ECCT’s
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Excellent, proactive and positive working relationships between representatives from
all facets of Emergency Care in these three DHB’s
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Quarterly all day meetings held in ChCh; other subgroup meetings as required
CANTERBURY WEST COAST MEMBERSHIP
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Hank Bader
Garth Bateup
Serena Bayles
Dr David Bowie
Margaret Bunker
Dr Robyn Carey (CHAIR)
Tim Chiswell
Dr Sandy Dawson
Simon Duncan
Maureen Frankpitt
Alan Goudge
Dr Alistair Humphrey
Eldon Macarthur
Donna McCann
Graeme McColl
Shane McKerrow
Dr Roger Mills
Sharon North
Michelle Prier
Sandy Richardson
Dona Shiell
Barbara Smith
Yvonne Stuart
Dr Martin Than
Craig Woodham
Dr Rex Yule
Marinda Hawthorne
Clinical Standards Manager, St John
GM Rural Services and Ashburton Hospital
Assoc Director NICU, ChCh Womens Hospital
Intensivist ICU and Emergency retrievals
Secondary Care, Planning and Funding, CDHB
Emergency Doctor, ED, Timaru Hospital
Emergency Planner, St John
Ministry Of Health
Manager, Garden City Helicopters
Nurse Manager, Community Primary Health, WCDHB
Manager, SouthComm, St John
Medical Officer of Health, ChCh Community and Public Health
Planning & Development Manager, St John Communications
Service Leader, Medical and Specialty Services, Timaru Hospital
Emergency Planning, Ministry of Health
Transport Co-ordinator, ChCh Hospital
GP / ED Grey Hospital
Clinical Nurse Manager, Wairau Hospital
Chair Canterbury West Coast College of Midwives
Research Nurse, ED, ChCh Hospital
Programme Manager, Primary Care, ACC
Nurse Manager, Murchison Hospital
Project Manger, Partnership Health PHO
Emergency Physician, ED, ChCh Hospital
Operations Support, St John
Rural GP and PRIME
Co-ordinator / Projects
KEY PROJECTS
STEMI FAST TRACK INITIATIVE
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First Ambulance to Cardiology ECG transmission on November 13, 2006.
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Life-threatening cases managed through the expedited coronary angioplasty pathway, with
improved door to balloon times and patient outcomes as a result.
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Project exemplifies achievement of different health care providers working
together for patient benefit - (ECCT, St John, Christchurch Hospital Cardiology and
Emergency Departments and MedXus)
MATERNITY AND AMBULANCE SERVICES SURVEY
Completed in 2006.
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Results published in two arms – Maternity Care Providers Survey and Emergency
Ambulance Services Survey
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Results: Key recommendations made for improvement in both sectors, MoH to review
maternity ambulance funding, greater linkages and inter-sector understanding and training
achieved.
KEY PROJECTS
WEST COAST PRE HOSPITAL THROMBOLYSIS
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Joint project seed funded by ECCT with ongoing costs met by WCDHB
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Training Rural Nurses and Doctors in administration of pre hospital thrombolysis
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Project exemplifies achievement of different health care providers working together for
patient benefit - (ECCT, West Coast District Health Board – Rural Nurses and GP’s ,
PRIME , St John, Christchurch Hospital Cardiology, Dunedin and Dunstan Hospitals)
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Implementation November 2007 (awaiting first patients)
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Considered a New Zealand first for rural nurses services to administer thrombolysis
WEST COAST CARDIAC OUTCOMES SURVEY
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Seed funded by ECCT in conjunction with West Coast DHB
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Aims to retrospectively explore disparities between patient outcomes in a rural isolated
setting vs. urban setting
KEY PROJECTS
DEFIBRILLATOR MAPPING
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in conjunction with O/S ECCT and SouthComm
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tracking placement of all South Island defibrillators
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SouthComm to map onto Computer Aided despatch using GPS co-ordinates
HELIPAD CHRISTCHURCH HOSPITAL
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Active campaigning by ECCT over several years to resolve lack of suitable helipad at
Christchurch Hospital . Work continues on this project
FUTURE PROJECTS
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Information sharing from community through to admission - trial proposed for South
Canterbury in conjunction with St John SouthComm and road ambulance services
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West Coast after hours issues especially rural sector
Development of “See and Treat” protocols for Emergency department nurses
GPS “tagging” of key sites within Rural District Councils in conjunction with St John and
SouthComm
OTAGO / SOUTHLAND
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Inception 2002
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Co-ordinator appointed 2002. Was full time until 2006. Role in recess for one year due to
staffing issues
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Now co-ordinator working 0.4 FTE ECCT/ 0.6 FTE ICU
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Contract held with ODHB based in Dunedin
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Active ongoing membership from ODHB and SDHB
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Linkages nationally with other ECCT’s
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Excellent, proactive and positive working relationships between representatives from all
facets of Emergency Care in these two DHB’s
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Quarterly all day meetings held in various locations throughout Otago /Southland and
sub group meetings as required
OTAGO SOUTHLAND MEMBERSHIP
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Pam Adams
Ray Anton
Dr Matt Born
Kathryn Brookes
Pauline Buchanan
Dr John Chambers
Michael Dodds
Marg Eckhoff
Dr Pat Farry
Doug Flett
Robert Gonzales
Alan Goudge
Carol Gray
Tony Hill
Dr John Holmes
Dr Mike Hunter
Linda Koks
Dr Sampsa Kiuru
Graeme McColl
Lloyd Matheson
Dr Roy Morris
Nicki Pealing
Dr Pete Rodwell
Leanne Samuels
Dr Claudia Schneider
Dave Seque
Dona Shiell
Dr Mathew Stokes
Doug Third
Coordinator / Registered Nurse, ICU Dunedin Hospital
CEO Clutha Health First, Balclutha Hospital
Medical Officer, Dunstan Hospital
Clinical Nurse Manager, ICU, Dunedin Hospital
District Operations Manager, St John Southland
Clinical Director, Emergency Department, Dunedin Hospital
Service Manager, Surgery, Anaesthetics and ICU, Dunedin Hospital
Rural / PRIME Nurse, Otago region
GP, Dunedin
Chief Crewman / Paramedic, Otago Air Emergency Rescue Trust
CEO Waitaki Health, Oamaru Hospital
Manager, SouthComm, St John
ODHB Planning and Funding
Manager, Lakes District Air Rescue Trust, Queenstown
Medical Officer of Health, Otago
Clinical Director, Intensive Care, Dunedin Hospital
Clinical Nurse Manager, ED, Dunedin Hospital
Emergency Department Consultant, Southland Hospital
Emergency Planning , MoH
Operations Manager, Southern Lakes Helicopters, Te Anau
Urban GP, Dunedin
LMC, Midwifery Department, Otago Hospital
Emergency Department Consultant, Oamaru Hospital
Director of Nursing, Southland Hospital
Clinical Director, Intensive Care, Southland Hospital
Chief Fire Officer, Otago Fire Service
ACC Programme Manager, Primary Care
Rural GP / PRIME, Southland
Regional Operations Manager, St John Otago / Southland
KEY PROJECTS
Kiwi CARPA
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Standardised treatment Manual for remote and rural nurses / GP’s
Treatment guidelines developed and reviewed by clinicians using the guidelines
Developed on Australian model Central Australian Rural Practitioners Association)
Collaborative project between O/ S ECCT, Southland and West Coast DHB’s, NZ Institute
of Rural Health and ACC
Published and distributed for use throughout rural NZ
DEFIBRILLATOR MAPPING
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Sites throughout Otago / Southland mapped with GPS via SouthComm
INTERNAL CHIEF EMERGENCY PHYSICIAN TRAINING COURSE ON MASS
CASUALTY INCIDENTS
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Provision of 7th international ITAACS conference 2005
KEY PROJECTS
PRE HOSPITAL FIBRINOLYSIS
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Expansion of existing service throughout Otago to other sites in region
Aim for equity of access for rural AMI patients
Developed extensive teaching programme for GP’s, nurses and paramedics in
conjunction with Dunstan and Dunedin Hospitals
NATIONAL AND REGIONAL TRAUMA DATABASE
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Instrumental in background research, development and scoping of project
Part of ACC review group to assess Australian models
Trial of software as pilot to future project implementation
MEDICAL EMERGENCY TEAMS
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Development of scoring system for evaluation of rapidly deteriorating acute patients
Allows escalating response to patients needs
KEY PROJECTS
OBSTETRIC / NEONATAL RETRIEVALS
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determines optimal expertise mix when retrieving woman in labour, impending birth or
neonate
very clear and concise, time saving and determines easily which team members to take
GUIDLELINES FOR DEVELOPMENT OF OPTIMAL USE OF HELICOPTER
TRANSPORT IN EMERGENCIES
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Draft under discussion with potential for national use
FUTURE and CURRENT PROJECTS
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Community First response fully functional in Southland; expansion into remote Otago
Further thrombolysis sites throughout remote rural sites
Southland Hospital - aiming for accreditation for Registrar training
After Hours issues – regional solutions
Digital X Ray transmission issues between Oamaru and Dunedin Hospital
Wanaka / Queenstown / Central Otago issues of huge increase in demand for emergency
services during ski season and increasingly throughout the year.
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Joint ACC/MoH meetings including ECCT held June 2008 plus all stakeholders
involved in emergency care in Wanaka / Queenstown region
THE FUTURE
How can ECCT’s be best utilised within DHB’s
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Expertise
Existing networks
Individual projects
Linked projects
Lobbying
Liaison
How can DHB’s maximise ECCT’s presence within
their organisations?
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? Link into existing DHB networks ? Which ones
Be consulted in planning future DHB projects / initiatives
Approach ECCT in all aspects of pre hospital emergency healthcare issues