MedSTAR is SA Ambulance Service’s unique 24-hour emergency medical retrieval service. It provides South Australians with the highest level of emergency medical patient care, treatment and transport from any location in the State to the most appropriate medical facility. Coordinating patients’ medical care, transport and retrieval, MedSTAR is a one-call service.
Overview
MedSTAR provides a 24/7 specialist medical retrieval service which requires rapid clinical response for patients needing critical care and transport including emergency ambulances, air planes and helicopters. The key to MedStar operations running successfully is the ability to coordinate their efforts with the help of a reliable and efficient communication/conferencing technology. The system is for all phone communication both in and out of the service. The number of such calls is up to 400 per day.
“ADTEC system is absolutely invaluable, especially for paediatrics and neonatal cases where you often need multiple consultants advise and support and everybody has to be on the same page with regards to the stability of the patient”
Natalie Hincksman
Advanced Nurse Unit Manager, Rescue Retrieval Aviation Services, MedSTAR
Challenge
The legacy system used by MedSTAR was a manual system implemented on the operators extension. Operators had to manually dial people in, using the * button to get in and out of conference. Only a single conference could be accessed and operators were not able to always be in the call, if they were calling additional people or attending to other parts of their role. It was clunky, if participants dropped off there was no indication, or if they had locked somebody out, there was no way to know as there was no visual or audible indication. It had no recording or auditing capability and the NRC(Nurse Retrieval Consultant) were forced to remember the conversation which introduced an additional element of risk to patient safety.
The NRCs were forced to take one call at a time. If there were multiple issues or patients (eg. mother and child) it was almost impossible to have all the relevant specialists connected. It also affected the quality of information, which was often relayed second hand, forcing the specialist to make a blind decision thus increasing the risk for critical patients as they would miss clinical information.
MedSTAR believes that when it comes to patient care, especially for critical patients, a team approach is the best approach. The legacy system didn’t allow for the team approach to provide better care utilising advise and expertise of the whole team of relevant and different specialists. Specialists couldn’t communicate directly with each other and the MedSTAR team within the same system at the same time. In the event they had a single case involving two or more patients eg. in the event of a difficult birth requiring obstetrician and neonatal specialist, to organise a complete response addressing both the patients with both specialists coordinating their efforts was not possible.
The Solution
MedSTAR implements the ADTEC system to address the above challenges and improve patient outcome by allowing them to quickly get consultant help.
MedSTAR have experienced significant efficiency gains as the system allows them to pull multiple people into a single conference easily as they have access to all system functions in one area.
The ability of the ADTEC system to allow NCRs to have multiple calls simultaneously by dropping out of the call to attend to another call and coming back in, has also resulted in reducing average call time. Comprehensive analytical reports from the system helps MedSTAR to see operators making simultaneous calls allowing for productivity gains. One of the key benefits of the reporting capability has been the improvement of MedSTAR shift patterns. By identifying call overflow days and times, they have been able to achieve appropriate staffing levels which is crucial for patient outcomes. The reporting also helps MedSTAR address staff fatigue issues from WHS perspective.
MedSTSAR believe the fact that ADTEC system allows NCRs to listen to the call, document it and then effortlessly listen to it again, has improved patient safety. As Natalie Hincksman, Advanced Nurse Unit Manager states; “It was very cumbersome before. The information we are getting now is better”.
ADTEC offers many value added functionalities such as call recording and retrieval. “The NCRs quite often retrieve the calls for Coroners and Crown Solicitors, its quite easy and quick”, says Natalie. “What’s really nice is that you are not pulling multiple calls of a case separately, but one single recording”, she adds.
Natalie’s favourite feature is transportability. As she explains - “we can log into the system from any desk. The cloud delivery of the system is very critical and fits into our business continuity plans”.
“Additionally, ADTEC’s backup functionality has also helped us a lot. We have had a few general phone system outages and MedSTAR was the only service not affected”, Natalie adds.
In general, according to MedSTAR users, the ADTEC system has made it easy to identify cases and equally easy to follow up cases. The ADTEC conferencing function has provided MedSTAR better visibility, as Natalie comments - “it's hugely important to be able to see who is in the conference in order not to call the same specialist consultant to multiple conferences simultaneously”.
Natalie recalls a critical incident where ADTEC system capability allowed them to bring in an obstetrician as well a neonatologist into the conference. “We can now mount a response for two patients - an adult and a baby in less than 10 minutes, it's quite phenomenal. We couldn’t do it before”.
Natalie Hincksman ends by stating that she believes Communications Centre is a reliable and robust system, backed by a responsive support team who are able to provide quick resolutions and workarounds.