National Ambulance Service Strategic Plan Vision 2020 Staff Focus Group Meetings 2015 Rivers Building Tallaght Kilkenny and Cork Limerick and Galway Mullingar Donegal Kells • October 23 rd O ctober 27 th November 2 nd November 19 th November 27 th December 4 th • October 28 th • October 29 th Facilitators: Damien McCallion Martin Dunne Vincent Cronly 1
• Introduction – Damien • Presentation Vision 2020 Strategic Plan – Vincent • Discussion Session – Martin • Session Close – Martin 2
Background • Enables clarity for staff, patients and general public on direction of ambulance services • Framework for the next 5 Years - Process running over 12 months – workshops, international literature review - External input sought from >10 key partners including National Patient Forum - Consolidate all reviews and feedback into one single coherent plan • Vision 2020 Steering Group Acute Hospitals, Primary Care, Quality Improvement, Health & Wellbeing and other key HSE Divisions 3
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Vision 2020 Presentation Overview • Context for our Strategic Plan • Our Goals and Objectives • Draft Implementation Plan 5
Service Reviews and Plans Internal HSE HIQA Quality and Carndonagh Review Review Patient Investigation Safety Plan • • Completed mid 2014 Completed Dec 2014 • Completed Oct 2014 • • Commissioned as a result of Key findings focused on • Initiated as a result of a • concerns from HIQA to provide improving operational Commenced Q4 2014 tragic death in LGH assurance performance, effective • Ambulance turnaround • QIP developed to improve • Review team comprised of leadership and mgmt, framework developed as a quality and safety of services senior HSE mgmt outside of alternative models of care, consequence NAS DFB relationship and better • Implementation Group in ownership. place Fleet & Review of Capacity HR and OD Equipment Services in Review Development Strategy Dublin Strategy • Completion October 2015 • Focused on improving NAS • Commenced April 2015 • • Commenced May 2015 Target Q4 2015 operational performance • Target Q4 2015 • • Target Q4 2015 Jointly commissioned between • Key will be technology, • Focused on developing a • Focused on ensuring an HSE & DCC dynamic deployment, clear people and • appropriate and cohesive fleet TOR to identify optimal additional resources and organisation strategy plan, systems and structure to approach for Dublin community response. 2020
Key Challenges • Improve quality and patient safety systems, such as clinical audit • Improve performance through dynamic deployment, single dispatch centre, and focus on patient outcomes • Improve service in Dublin with Dublin Fire Brigade • Develop and implement new models of care • Ensure organisation is modern and fit for purpose • Address manpower challenges to increase staffing in key areas • Integrate ICT Systems • Modernise fleet, infrastructure & control systems • Improve our approach to patient engagement 7
SWOT Analysis – NAS Vision 2020 Strengths Weaknesses Statutory Patient service provider , public and stakeholder engagement Patient centred s Variations in service delivery ervices Professional, skilled and motivated workforce Inconsistentresponse targets External accreditation of staff and systems competencies Often over-stretched resources Experiencedconsultant Need to continue to find recurring cost savings year on year teams utilisedfor key specialists subjects Enthusiastic workforce committed to improving patient centred services Limited clinical audit High vehicles, equipment and technologyinvestment Financial balance consistentlydelivered Good relationships with stakeholder organisations Innovativeand dynamic in our drive for continuous improvement Increasing community involvement Opportunities Threats Improvingnational fiscal position Strategy dependent on additional funding Development of national integrated care programmes Funding not keeping pace with demand Improved governance Workforce/recruitment constraints , management and leadership arrangements – competition from other providers Increased capacitybased on review recommendations Lack of resources may inhibit future service delivery/growth Involvement of Stakeholder resistance to change staff, public , patients and stakeholders in service development An open learning environment Setting of unattainable targets Increasing pace of change in clinical practice Individual workload Promotion of innovation, research and education Unpredictableservice demandsmay impact on implementation timescales Staff development through implementation of new systems and processes Future politicalchanges may significantly influence delivery priorities New systems to provide a more efficient and effective service to patients Non implementation of review recommendations (HIQA, PHECC, Lightfoot) Improved business continuity / resilience 8
Emerging and International Trends in Pre-Hospital Emergency Care • Increasing demand at 3-5% per annum. • Developing alternative Models of Care: – Hear and treat call in Emergency Operation Centre –“ low acuity ” – Alternative destinations for patients other than ED – minor treatment centres – Treat and discharge patients where hospitalisation not required – Care Bundles for specific groups of patients • Integrating within the broader health care system; Emergency and Urgent Care with hospitals and primary care • Infrastructure investment and development – technology driven performance improvements in response times • Leadership & workforce development (inc. paramedic shortfalls) • Moving from single target focus on time based targets to broader set of measures focusing on outcomes • Use of dynamic deployment to improve response times • Use of Community First Responder Schemes in rural areas 9
Sets out the HSE goals to improve the health service which are incorporated within the National Services Planning process 10
Our Strategic Goals 11
Our Goals, Objectives and Projects Goal 1 Promote Health & Wellbeing as part of everything we do so that our patients and staff will be healthier What we will do Play an active role in improving population health needs • Engage with Health and Wellbeing community promotion programmes • Participate in the delivery of community based educational/ training programmes • Develop and implement a public information campaign – appropriate use of 112/999 and use of alternative care pathways Ensure a prevention focused approach to staff health and wellbeing • Implement the Health Ireland Framework within the NAS • Review NAS policies, procedures and practices to maintain staff safety and welfare • Improve occupational health support to NAS 12
Our Goals, Objectives and Projects Goal 2 Provide fair, equitable and timely access to quality, safe emergency services that people need What we will do Improve quality of care and patient safety • Implement an electronic patient care record (ePCR) • Introduce additional clinical performance measures • Develop and implement clinical support capacity Develop alternative models of care • Implementation of Hear and Treat in NEOC • Establish and agree basis for handling routine activity • Implement paramedic treat and discharge protocols Seamless, responsive and safe service in Dublin region • Implement recommendations of the review group Improve operational performance • Implement real-time performance and quality dashboard • Improve ambulance turnaround performance • Implement additional capacity • Optimise the location of ambulance resources • Expand national linked Community First Responder schemes • Expand retrieval services 13
Our Goals, Objectives and Projects Goal 3 Foster a culture that is honest, compassionate, transparent and accountable What we will do Improve our engagement with patients and service users • Develop and implement a Patient and Service User Engagement Strategy • Implement a NAS patient forum Become more transparent and open with our patients, the public and staff • Continue implementation of the HSE Open Disclosure National Policy – near & adverse advents • Continue implementation of the National Standards for Safer Better Healthcare • Implement the National Incident Management System and Complaints & Compliments Management System • Carry out an annual staff survey & implement an annual action plan on feedback • Strengthen leadership capacity to manage change – facilitative management style 14
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