We gave advice to members last week about our long term bans around significant ramping safety concerns and we met with Ambulance Tasmania about this yesterday.
Essentially, our bans will be incorporated into future ambulance and hospital protocols and policies, but please continue the bans until that occurs.
Some of this implementation may become formal policy as early as tomorrow.
- AT is working on criteria for patients to be sent for triage in the waiting room, or be sent to the waiting room after triage, allowing for crews to be immediately released after PCR.
- AT agrees we are not to keep a patient after an X-ray or CT scan. You can push them in but, once there, the patient belongs to the hospital and clinical handover must occur.
- AT agrees that interventions such as taking bloods, IV drugs and drugs beyond the AT scope of practice shouldn’t happen when someone remains an AT care patient. If the intervention is required it must be after clinical handover/transfer of the patient.
- AT agrees they want you to SRLS delays of triage that exceed 5 minutes, and they need this data. You can use the “VACIS Toughbook” to submit an SRLS, or a PC in the ramping areas. If unable to do an SRLS email your R-DM.
- AT wants you to accurately update your “status” when ramped as they don’t fully trust the hospital data.
- AT will be using a more robust process to get crews released when resources hit around 70-80% used (TBC) within an urban region because it’s too late to seek release when a P-0 or P-1 comes in and there’s no response available.
- AT agrees that crews shouldn’t accept multiple ramped patients managed by a single clinician or crew. It’s not normal practice and shouldn’t be expected.
- AT agrees rendezvous with BSOs should become normalised so BSOs get back to their regions ASAP.
- AT will expand secondary triage in time and have a transport to hospital via taxi process in place rather than relying only on EMS for all transport.
- AT agrees that unless it’s an emergency, inter-hospital transfers don’t start without a confirmed bed at the receiving hospital. These patients won’t be admitted via DEM and rendezvous should occur when crews change regions.
- AT intends to use AMR fixed wing for more inter-hospital transfers, particularly NWRH-LGH transfers.
We think these are significant changes, and AT is finally listening and has pushed the hospitals to listen too. Congrats to Joe and James for taking this seriously at long last!
If you have any questions, feel free to call me on 1300 880 032.