Excellence in Technology Ambulance Activity and Resource Model (AARM)

Hato Hone St John

Team: Dave Richards, Robbie Blankenstein, Zoltan Varadi, Max Yang, Dale Truman

Increased demand for emergency ambulance services (EAS) in Aotearoa New Zealand led to demand exceeding available resource. As a result, patients were waiting longer, ambulance utilisation had reached unsafe levels for staff and contractual targets were not being met. This had been compounded by reduced volunteer contribution. As NZ moves to living with COVID-19 in the community, it is essential that the ambulance service has the resilience and capacity to be able to respond. International experience is showing that there are ambulance demand surges associated with community outbreaks of COVID-19 and a backlog of acute presentations to emergency services where the pandemic has interrupted diagnosis and treatment for diseases.

To address these issues Hato Hone St John worked with our funders to identify and articulate the resource requirements to meet response time targets. We took them on the journey and involved them in deciding the inputs/assumptions, showing the results of decisions on model iterations with simulations.

The Ambulance Activity and Resourcing Model (AARM) was created to determine the level of resource investment required for the next four years to adequately service the forecasted demand and achieve government set response targets. The AARM defines a set of demand and resource inputs/assumptions and uses CSAM Optima predict simulation to determine resource requirements.

This new approach of including the funders in the AARM process was ultimately successful with full funding for one of the modelled options. Not only that, the new contract defines the AARM as the process of using agreed assumptions and simulation to determine future resource requirements.

Our research shows that shows that as utilisation increases, staff get fewer breaks, resulting in more sick leave and more fatigue. Ultimately, when we look after our staff they provide better care, and patient satisfaction improves. It is also easier to attract and retain employees.