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Australasian Ambulance Winter 2018 CAA Awards Finalists and Winners Announced August 2018

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Australasian Ambulance Winter 2018 CAA Awards Finalists and winners announced August 2018 The Patient: At the centre of everything we do Ko te tūroro: Ki te pokapū o mātou mahi CAA Awards for Excellence: Innovative projects and research for out-of-hospital care in Australia and New Zealand CAA Awards for Excellence 2018 Accreditation Award Presented to SA Ambulance Service The first CAA service to achieve NSQHS standards accreditation CAA congratulates SAAS on being the first ambulance service in Australia to receive National Safety and Quality Health Service (NSQHS) accreditation and the first to receive the CAA Accreditation Award. The inaugural Accreditation Award has been incorporated in the CAA Awards for Excellence in recognition of outstanding commitment by an ambulance service to achieving the rigorous standards applied to the health sector in Australia. The standards set by The National Safety and Quality Health Service (NSQHS) are mandatory for health service organisations but not ambulance services. An external assessment determines ultimate accreditation, which is reassessed every three years. SAAS has demonstrated a commitment to continuously review and improve its operations to deliver optimum out-of-hospital care in South Australia under the scrutiny of external assessors. WINTER 2018 3 Australasian Ambulance – Awards edition 2018 This special awards edition of the Australasian Ambulance Magazine Clinical Clinical Capability Projects encapsulates the remarkable breadth of the Entries relate to patient treatment and outcomes, work undertaken by ambulance services and paramedics in Australia and New Zealand. including skills mix, pharmacology and clinical intervention. An impressive 38 entries for CAA’s 4 – 13 Awards for Excellence spanning projects and research in four separate categories highlight outstanding skills and a commitment to fostering healthy communities. Education Educational Performance Projects This year we also recognise the SA Entries Ambulance Service (SAAS) achievement may include program design, delivery, assessment in being the first ambulance service in and accreditation; professional development, skills Australia to receive accreditation by the 14 – 24 maintenance and practice standards; community National Safety and Quality Health Service education; and research or innovation supporting (NSQHS). evidence based practice. With the constant demands on all levels of the ambulance workforce, it is important to remind ourselves of the unstinting and inspired efforts of the individuals and Management Management Practice Projects teams whose contributions make a positive Entries relate to improvements in management culture, difference to the sector and the community. open communication, accountability, management The magazine provides an opportunity to 25 – 34 development, professional standards, diversity of showcase their work and hopefully act as workforce and operational protocol and work practices another trigger for services to share their concerning the provision of service delivery. expertise and knowledge, at home and abroad. We are delighted to have the continued support of SDSI as sponsor of the 2018 Technical Technical Capability Projects Awards for Excellence Gala Dinner, Entries relate to equipment, fleet, workshops, bases, celebrated in Auckland, New Zealand in communications and information systems. conjunction with the CAA18 Congress. 35 – 42 Our expert judges have again given generously of their time. Sincere thanks to Steve Irving, Executive Officer, Association of Ambulance Chief Executives (UK) and former members of the CAA Board Lyn Pearson, Ross Coburn and Greg Sassella. Links to previous projects highlighted in the CAA Award magazines can be found at CAA’s Australasian Ambulance new website: www.caa.net.au Produced by: Winter 2018 Cover: CAA Awards The Council of Ambulance Authorities Finalists and winners announced August 2018 Images provided by The Patient: At the centre of everything we do c/PO BOX 714 Wellington New Zealand Ko te tūroro: Ki te pokapū o St John New Zealand and mātou mahi Editors: Chris Hornsey, Helen Conlin Wellington Free Ambulance. www.caa.net.au August 2018 CAA Awards for Excellence: Innovative projects and research for out-of-hospital care in Australia and New Zealand Disclaimer: This document has been prepared to promote and inform discussion. All images reproduced with the permission of relevant ambulance services. David Waters Chief Executive, CAA 4 CAA MAGAZINE ACT-FAST clinical triage algorithm CLINICAL for stroke clot retrieval Dr Henry Zhao (Principal Investigator, Royal Melbourne Hospital & Ambulance Victoria) and Professor Karen Smith (Ambulance Victoria) A unique tool to detect patients with the most severe form of stroke and to triage them to appropriate treatment more easily and quickly has been designed by a team of Melbourne researchers in conjunction with Ambulance Victoria. Background For many stroke victims needing the highly effective clot retrieval surgery, treatment can be badly delayed as they do not live near a specialised hospital capable of performing the procedure. In such a debilitating form of stroke where every minute counts, such delays lead to dire and leg weakness (often confounded by rural Victoria, assessing ACT-FAST will consequences including worsening brain hip problems), making them impractical allow paramedics to provide early warning tissue death and poorer outcomes. for real world use. to the hospital and to the neurologist To counter this problem, the Royal through the Ambulance Victoria rural The objectives of creating such a tool were stroke telemedicine project to expedite Melbourne Hospital in collaboration with as follows: Ambulance Victoria created an innovative transfer for clot retrieval surgery. three-step ACT-FAST paramedic algorithm • Streamlined paramedic algorithm with With increasing implementation across to identify patients likely to need clot no scoring required Victoria, the team will look to collaborate retrieval, thereby allowing ambulances with ambulance and hospital services to transport patients directly to an • Least number of examination items as possible nationally and internationally to improve appropriate hospital. The streamlined care for stroke patients and reduce clinical algorithm allows paramedics to • Examination items must be able to inequality for those living far away from quickly and easy apply the tool in the be assessed reliably in real world specialised clot retrieval hospitals. field and requires assessment of just two situations (e.g., uncooperative and examination items for each patient. non-English speaking patients). Evaluation Use of this tool in future is envisioned Implementation Preliminary data of ACT-FAST accuracy to provide a simple and cost-effective show that paramedics assessing patients solution to avoid costly transfers between The 3-step ACT-FAST algorithm (seen as algorithm positive predicted need hospitals and significantly expedite clot in the picture above) was developed for clot retrieval with >90% accuracy retrieval treatment to achieve better in many stages with the collaboration and surpassed the accuracy of the more outcomes for stroke patients. of Ambulance Victoria paramedics. complex international tools. For patients An extensive study was conducted that could not receive clot retrieval at Aim investigating how stroke patients requiring their closest hospital, more than an hour The project aimed to create a simple and clot retrieval present differently from would have been saved had paramedics easily deployable paramedic procedure for other types of stroke, and examination used ACT-FAST to triage patients to a identification of stroke patients requiring items were tested for practicality and specialised clot retrieval hospital. reliability when used by paramedics. clot retrieval surgery. Initial evaluation of the ACT-FAST Existing international triage tools such as A validation study is currently underway in Algorithm therefore shows that the the Rapid Arterial Occlusion Evaluation Melbourne to test the accuracy and time tool is practical, simple, highly accurate, scale (RACE) are time consuming and saving potential of the ACT-FAST algorithm and is modelled to provide substantial demand that up to six examination items when used by paramedics. Should in-field time saving for clot retrieval treatment. be performed on top of routine paramedic testing continue to be successful, the final Implementation of ACT-FAST in future is assessments for stroke. In addition, many stage of implementation will involve all therefore hoped to provide stroke patients use unreliable examination items like ACT-FAST algorithm positive patients being with the best chance of recovering from facial asymmetry (can be very subjective) taken directly to an endovascular centre in this debilitating condition. metropolitan Melbourne. For patients in WINTER 2018 5 CLINICAL Melbourne Mobile Stroke Unit Shane Foster, Project Manager (Ambulance Victoria), Lindsay Bent (Ambulance Victoria), Michael Stephenson (Ambulance Victoria), Stephen Davis (Royal Melbourne Hospital), Geoffrey Donnan (Royal Melbourne Hospital), Henry Zhao (Royal Melbourne Hospital and Ambulance Victoria) Stroke is a major contributor to Australia’s burden of disease and a leading cause of disability costing the health system $5 billion annually. In 2017, there were almost 56,000 new and recurrent stroke incidents. With every minute that passes without treatment, Photo: Herald Sun it is estimated approximately
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