Vision 2020 Staff Focus Group Meetings 2015 Rivers Building - - PowerPoint PPT Presentation

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Vision 2020 Staff Focus Group Meetings 2015 Rivers Building - - PowerPoint PPT Presentation

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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

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SLIDE 1

Rivers Building Tallaght October 23rd

  • October 28th
  • October 29th
  • Kilkenny and Cork

October 27th Limerick and Galway November 2nd Mullingar November 19th Donegal November 27th Kells December 4th

National Ambulance Service Strategic Plan

Vision 2020

Staff Focus Group Meetings 2015

1

Facilitators: Damien McCallion Martin Dunne Vincent Cronly

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SLIDE 2

Introduction – Damien

  • Presentation Vision 2020 Strategic Plan – Vincent
  • Discussion Session – Martin
  • Session Close – Martin
  • 2
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SLIDE 3

3

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

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4

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SLIDE 5

Context for our Strategic Plan

  • Our Goals and Objectives
  • Draft Implementation Plan
  • Vision 2020 Presentation Overview

5

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SLIDE 6

Internal HSE Review

Completed mid 2014

  • Commissioned as a result of
  • concerns from HIQA to provide

assurance Review team comprised of

  • senior HSE mgmt outside of

NAS

HIQA Review

Completed Dec 2014

  • Key findings focused on
  • improving operational

performance, effective leadership and mgmt, alternative models of care, DFB relationship and better

  • wnership.

Capacity Review

Completion October 2015

  • Focused on improving NAS
  • perational performance

Key will be technology,

  • dynamic deployment,

additional resources and community response.

HR and OD Development Strategy

Commenced April 2015

  • Target Q4 2015
  • Focused on developing a
  • clear people and
  • rganisation strategy

Review of Services in Dublin

Target Q4 2015

  • Jointly commissioned between
  • HSE & DCC

TOR to identify optimal

  • approach for Dublin

Carndonagh Investigation

Completed Oct 2014

  • Initiated as a result of a
  • tragic death in LGH

Ambulance turnaround

  • framework developed as a

consequence Implementation Group in

  • place

Fleet & Equipment Strategy

Commenced May 2015

  • Target Q4 2015
  • Focused on ensuring an
  • appropriate and cohesive fleet

plan, systems and structure to 2020

Quality and Patient Safety Plan

Commenced Q4 2014

  • QIP developed to improve
  • quality and safety of services

Service Reviews and Plans

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SLIDE 7

Key Challenges

7

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
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SLIDE 8

8

SWOT Analysis – NAS Vision 2020

Strengths

  • Statutory

service provider

  • Patient centred s

ervices

  • Professional, skilled and motivated workforce
  • External accreditation of staff and systems competencies
  • Experiencedconsultant

teams utilisedfor key specialists subjects

  • Enthusiastic workforce committed to improving patient centred services
  • High vehicles, equipment and

technologyinvestment

  • Financial

balance consistentlydelivered

  • Good relationships with stakeholder organisations
  • Innovativeand dynamic in our drive for continuous improvement
  • Increasing community involvement

Weaknesses

  • Patient

, public and stakeholder engagement

  • Variations in service delivery
  • Inconsistentresponse targets
  • Often over-stretched resources
  • Need to continue to find recurring cost savings year on year
  • Limited clinical audit

Opportunities

  • Improvingnational fiscal position
  • Development of national integrated care programmes
  • Improved governance

, management and leadership arrangements

  • Increased capacitybased on review recommendations
  • Involvement of

staff, public , patients and stakeholders in service development

  • An open learning environment
  • Increasing pace of change in clinical practice
  • Promotion of innovation, research and education
  • Staff development through implementation of new systems and processes
  • New systems to provide a more efficient and effective service to patients
  • Improved business continuity / resilience

Threats

  • Strategy dependent on additional funding
  • Funding not keeping pace with demand
  • Workforce/recruitment constraints

– competition from other providers

  • Lack of resources may inhibit future service delivery/growth
  • Stakeholder resistance to change
  • Setting of unattainable targets
  • Individual workload
  • Unpredictableservice demandsmay impact on implementation timescales
  • Future politicalchanges may significantly influence

delivery priorities

  • Non implementation of review recommendations

(HIQA, PHECC, Lightfoot)

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SLIDE 9

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
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SLIDE 10

10

Sets out the HSE goals to improve the health service which are incorporated within the National Services Planning process

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SLIDE 11

11

Our Strategic Goals

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SLIDE 12

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

  • Our Goals, Objectives and Projects

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Goal 1

Promote Health & Wellbeing as part of everything we do so that

  • ur patients and staff will be healthier
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SLIDE 13

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
  • Goal 2

Provide fair, equitable and timely access to quality, safe emergency services that people need

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Our Goals, Objectives and Projects

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SLIDE 14

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
  • Goal 3

Foster a culture that is honest, compassionate, transparent and accountable

14

Our Goals, Objectives and Projects

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SLIDE 15

What we will do Engage with and involve our staff in the provision of service Implementation of the ‘Public Health Services People Strategy’

  • Develop an annual communications plan that includes focus on staff
  • Provide clinical services ‘web’ and email access to NAS staff
  • Strengthen NAS leadership, workforce and governance structures

Implementation of NAS Human Resources and Organisational Development Strategy

  • Embed formal staff and managers performance management system
  • Implement recommendations of the Management Structure Review
  • Implement a management training and development programme
  • Provide a high quality, competent workforce to meet our model of patient care

Implement a comprehensive workforce plan

  • Increase staff numbers to meet international norms
  • Implementation of a comprehensive education and competency assurance plan
  • 3rd level educational programme for paramedics
  • Regular review of staff development needs
  • Goal 4

Engage, develop and valueourworkforceto deliverthebest possible emergency care and services to the people who depend on them

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Our Goals, Objectives and Projects

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What we will do Ensure that NAS fleet and equipment is appropriate for use Implement recommendations of the NAS fleet and equipment strategy

  • Ensure that NAS has effective infrastructure

Review NAS deployment points

  • Carry out a fit-for-purpose review of current and future NAS estate requirements
  • Commence estate upgrade and new build programme
  • Improve our service efficiencies and effectiveness through the use of technology

enabled solutions Develop NAS eHealth strategy

  • Continue the development of the NAS CAD system
  • Continue the introduction of mobile data terminals and navigation tool
  • Implement a single national rostering/time (CORE) system
  • Implement NAS payroll system
  • Goal 5

Manage resources in a way that delivers best health outcomes, improves people’s experience of using our services and demonstrates value for money

16

Our Goals, Objectives and Projects

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SLIDE 17

17

Implementation Plan

Implementation is subject to: Completion of Reviews, Strategies and Plans

  • Service Planning and Funding Dependent across the lifetime
  • f the strategic plan
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SLIDE 18

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Sample Implementation Plan

Goal Objective Project Start Finish Lead

National Standards for Safer Better Healthcare Goal 2 Provide fair, equitable and timely access to quality, safe emergency pre-hospital services that people need 2.1 Enhance clinical competencies and governance arrangements to improve quality of care and patient safety 2.1.1 Implement an Electronic Patient Care Record (ePCR) Q1 2016 Q4 201 7 N AS Medical Director 2.1.2 Introduce additional Clinical Performance Measures Q1 2017 Q4 20 20

2.6

2.1.3 Develop and implement a clinical support capacity Q1 2017 Q4 2018 2.2 Develop alternative models of care to ensure that patients are directed to or taken to the appropriate location for treatment 2.2.1 Develop and implement Alternative Care Pathways :

  • Implement Hear and Treat by setting up a clinical support

desk in the NAS National Emergency Operations Centre Q1 2016 Q4 2016

Care is provided through a model of service designed to deliver high quality, safe and r eliable healthcare.

  • Work with partners to establish an agreed

basis for handling rout ine activity with improved utilisation of ICV’s Q2 2016 Q4 2016

  • Implement Alternative Patient Destinations Model

Q3 2017 Q4 201 9

  • Treat and Discharge / See and Treat

Implement paramedic treat and discharge protocols Q3 2017 Q4 2018 2.3 Ensure a seamless, responsive and safe emergency ambulance service in the Dublin region 2.3.1 Assume res ponsibility for the integrated call taking and dispatching ofall emergency ambulance in Dublin Q2 2016 Q4 2016 Director NAS 2.3.2 Implement recommendations of the review of services in Dublin Q1 2016 Q4 2016 National Director NAS

2.4 Foster a culture of strong performance management to improve operational performance

2.4.1 Implement a real-time Performance and Quality Dashboard Q1 2016 Q2 2017 Director NAS 2.4.2 Develop a balanced set

  • f meas ure for emergency ambulance

service between response times and patient outcome meas ures Q1 2016 Q4 2016 2.4.3 Improve performance in the NAS NEOC through implementation of Capacity Review recommendations Q1 2016 Q4 2019 NAS HR Manager 2.4.4 Improve response times in urban areas with the recruitment

  • f additional staff

Q3 2016 Q4 2020 2.4.5 Improve performance for ambulance turnaround times with acute hospital division and ensure saf e handover of patients Q2 2016 Q4 2016 National Director NAS 2.4.6 Optimise the Locat ion of Ambulance Resources Director NAS

  • Fixed Locations

Q2 2016 Q4 2016

  • Implement recommended Dynamic Deployment Points to

both minor and major urban areas Q1 2017 Q4 2018 2.4.7 Expand the number of linked Community First Responder Schemes as recommended by the Capacity Review Q1 2016 Q4 2020 2.4.8 Expansion of the Paediatric Retrieval Service Q1 2016 Q4 2020 2.4.9 Expansion of Adult Retrieval Service Q1 2016 Q4 2020 2.4.10 Develop Aero Medical Services Q1 2016 Q4 2020 2.4.11 Assis ting in the deliver y of dedicated children’s ambulance service for routine, urgent and end of life journeys Q1 2016 Q4 2020

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Survey

19

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Consultation Feedback To Date

Survey Suggested Areas of Improvement Improve Staff Health and Wellbeing Develop Rosters Introduce Deployment Points Introduce Alternative Care Pathways Introduce Patient / Public Relations/Education Improve Management / Staff Engagement Improve Clinical Supervision / Audit Improve Staff Training & Development Improved Fleet and Equipment Introduce Management 24Hr Cover Increase Staffing Levels Improve relationship between Control and Operations Station Upgrade Improve operations with Dublin Service (DFB)

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Next Steps

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Review Questionnaire Feedback and Feedback from External Stakeholders

Review of Services in Dublin Fleet & Equipment Review HR and OD Development Plan Capacity Review

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Open Forum Discussion

22