Waiting times for patients being transferred between South Island hospitals have been significantly reduced, as part of a regional agreement with St John.
The arranged transfer of non-acute patients between hospitals previously relied on the availability of St John ambulances at the time of a request for a patient transfer. Following the new regional agreement, dedicated St John ambulances are available for inter-hospital transfers within agreed scheduled hours for each South Island DHB. The agreement was facilitated by the South Island Support Services Service Level Alliance – part of the South Island Alliance, a collaboration between the five South Island DHBs.
Ambulance journeys can now be planned to tie in with services at receiving hospitals, says Christine Nolan, acting General Manager of Nelson Marlborough DHB. “Prior to this agreement, patients had to queue and wait for an ambulance to become available. Some DHBs had their own agreement with St John, while others had no formal agreement in place for some time.
“Instead of invoicing for every single trip and every patient, we decided to focus on a scheduled 24-hour travel arrangement between hospitals. We knew that with some careful planning, we could provide a service to best meet patients’ needs, as well as reduce travel costs and save time.”
The agreement has already proven to increase efficiencies for both parties, says Christine. “St John is now able to provide staff and vehicles on a dedicated scheduled basis with the benefit to St John of a three year agreement. Patients no longer have to wait, and several vehicles are capable of transporting three patients at a time. As a result, our coordination has improved across the South Island.”
Chrissie Cope, St John Service Change Manager of the South Island says attempting to respond to short notice requests was challenging. “Now, we turn up at a prescribed time and the DHBs have been working internally to improve communication and planning. It’s a win/win all round, with patients firmly at centre.”
During the planning process, the number of anticipated journeys and kilometres St John travelled per annum was calculated, and a fixed cost has been set across the region so the service can maintain the required resources. By having a set annual cost for the service, irregular invoicing and payments have also been eliminated.
Rosalie Waghorn, Nurse Manager Clinical Services at Grey Base Hospital for the West Coast DHB, says the new service has been a very positive experience from a nursing and patient point of view. “Prior to this agreement, we would have to ring St John to see when an ambulance would become available and then call around our nurses to see who could coordinate with that time – it was quite ad hoc. Now, we have an ambulance and a driver here every day at 10am to leave for Christchurch.”
After the service began, three nurses were employed to share the transfer roster to travel with the patients, Rosalie says. “We decided to train our nurses to become prime responders, to enhance their skills should the patient deteriorate on the trip or if they are called as first responders to any events whilst on the road. We have also developed documentation to allow for better handovers between nursing staff at each end of the transfer.”