ISSUE 04 | MARCH 2021
Her Excellency
Dame Patsy Reddy
The Governor-General of New Zealand
Australian Stroke Alliance receives $40 million grant National Mental Health and Wellbeing Study of Police and Emergency Services
FRDOEWENLOAD OK
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TAPPING INTO CAA’S ONLINE PRESENCE TO ENGAGE AND CONNECT WITH THE AMBULANCE SECTOR When you join The Directory by CAA, you will be included in our fortnightly newsletters, on our social media channels, featured on a dedicated webpage on our site among other opportunities. Choose from three tiers that provide options to fit your requirements.
CONTACT NIKKI MURPHY ON NMURPHY@CAA.NET.AU FOR MORE INFORMATION AND TO GET INVOLVED
Dear friends and colleagues, Our first magazine issue for 2021 sees us celebrating some wonderful achievements, from the CAA2021 Women in Ambulance Honour Recipients to the $40 million stroke grant announcement that will see incredible developments in pre-hospital stroke care. Looking at the 60 inspirational women the CAA and our services get to recognise and celebrate in 2021, I cannot be prouder at seeing women succeed and build strong careers in our wonderful sector. Most are working mums, providers, carers and everything in-between while working demanding jobs as paramedics, call takers, managers and corporate team members, and some on the side throwing in volunteering just for the fun of it. We forget that not that long ago (only a matter of decades) women didn’t get the opportunities and support we now have, and while gender inequality is still ripe, and pay balance still holds its head high, it’s the words of our March cover star, the Rt Hon Dame Patsy Reddy ‘focusing and planning for the future’ that will see us making further changes to tackle these issues. We are excited to honour the CAA2021 Women in Ambulance Awards recipients from across all Australian, New Zealand and Papua New Guinea ambulance services for the tremendous work they do daily and for rising up and being role models to the next generations entering the ambulance and health sectors. Our March issue sheds light on the ground-breaking work done in pre-hospital stroke care, seeking to provide early access to stroke patients no matter where you live. We look at the three year Beyond Blue project ‘Answering the Call’ and the progress that was done and next steps following its completion. A busy start to the year that just might see us getting back to normality. As always thank you for picking up FIRST by CAA for your latest ambulance developments and stories. Grab a cuppa, take a minute and enjoy. Mojca xx
Contents ISSUE 04 | MARCH 2021
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Letter from the Editor
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Data First A snapshot into the workings of our world leading ambulance services.
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44
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Opinion First Julie Hughes, Founding Director of the Michael Hughes Foundation shares the importance of HeartSafe Communities.
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Services First
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Showcasing the latest ground-breaking projects from across CAA member services.
Latest news from around the ambulance sector.
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Industry First
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CAA First A preview of the year to come alongside congratulations to our CAA2021 Women In Ambulance Awards Honour Recipients.
Awards First Featuring two of the 2019 category winners, SA Ambulance Service and Ambulance Victoria.
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Feature First
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Focus First
In the lead up to 2021 International Women’s Day, we spoke with Rt Hon Dame Patsy Reddy to gain insight into her career and hear her thoughts on the progress of women in leadership roles.
The Australian Stroke Alliance has been granted $40 million from the Frontier Health and Medical Research initiative.
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www.caa.net.au
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84
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The CAA Webinar Series for 2021 has kicked off with a bang. Read what we learnt in our previous two webinars and hear about what’s coming up.
Ambulance Victoria’s Recycling Uniform Program.
Events First
Sustainability
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People First Meet the wonderful people that make up the Australasian ambulance services.
Partners First Meet our partners: UK-based Association of Ambulance Chief Executives (AACE) and Australasian College of Paramedicine (ACP).
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The Directory
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Research First Sharing the latest innovative research projects from around the ambulance world.
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Wellness First How much is your health worth? Plus, download Mitch’s ebook ‘Body Confidence (for Life!) Guide’ for FREE!
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Beyond Blue National Mental Health and Wellbeing Study of Police and Emergency Services
THE TEAM
PUBLISHED BY:
Editor: Mojca Bizjak-Mikic Relationship and Content Manager: Stephanie Hartley Graphic Design: Alpha State
The Council Of Ambulance Authorities 283 – 287 Sir Donald Bradman Drive Brooklyn Park SA 5032 Australia admin@caa.net.au
Magazine published from paper that is sustainably sourced.
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Data First
Ambulance Snapshot
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ach year the CAA collates data from across our members service that provide a snapshot into the workings of our world leading ambulance services.
The data is published across CAA platforms, provided on behalf of the Australian ambulance services to the Australian Government’s Productivity Commission Report on Government Services and used for comparison and benchmarking globally.
Ambulance stations & locations
Ambulances and other vehicles
Air ambulance aircraft
1,862
7,297
122
+
Salaried ambulance staff
22,768 6
2019-20 saw continued demand grow across Australia, New Zealand and Papua New Guinea ambulance services. Between large scale bushfires and the COVID pandemic our services were pushed to the limits in providing quality response and care to patients and their loved ones.
+
+
Volunteers & first responders
+
16,128 www.caa.net.au
+
Incidents reported to ambulance service organisations
4.5 million
*
Responses where an ambulance was sent to an incident
5.7 million
+
Patients assessed, treated or transported by ambulance service organisations
4.2 million
*
Calls made to 000 or 111
3.9 million
*
* Denotes Australia, New Zealand and Papua New Guinea Figures. + Denotes Australia and New Zealand Figures only
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Industry First
Industry News Wellington Free Ambulance Acting Chief Executive Sarah Lewis Sarah Lewis is the new Acting Chief Executive at Wellington Free Ambulance. As the Executive Director of Corporate Services since 2006, Sarah is well versed in the operational, logistical and financial areas of the organisation. What does the immediate look like? Sarah will be focused on engaging with Wellington Free Ambulance’s diverse community and driving the organisation through continued growth.
Health Navigators show the way SA Ambulance Service paramedics, Renee Vestris and Anita Trott, are playing a vital role in guiding patients to the most appropriate care for their needs. With 30 years on-road experience between them, Renee and Anita are now Health Navigators, tasked with helping other SAAS clinicians navigate an ever-growing range of alternate care pathways. Alternate pathways in South Australia include SAAS Extended Care Paramedics, Priority Care Centres, the Hospital Avoidance and Supported Discharge Service, Mental Health Coresponders and a new Urgent Mental Health Care Centre in the Adelaide CBD. As Health Navigators, Renee and Anita have a detailed understanding of these services so they can advise and broker referrals for patients who don’t require treatment at an emergency department. Health Navigators, Renee Vestris (rear) and Anita Trott.
New St John WA partnership with The Wiggles to support kids and families The global children’s juggernaut The Wiggles have joined with St John WA in a new three-year partnership to bring first aid education and understanding to children and families. In the first partnership of its kind in WA, kids across Western Australia will have more opportunities to learn about triple-zero calls, first aid, and what to do when emergencies happen before the ambulance arrives. The new partnership is part of St John WA’s vision for every school child to have access to free first aid training in WA to build stronger, more resilient communities.
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St John Ambulance Papua New Guinea new recruits The Ambulance trainees have commenced the St John Ambulance 16 weeks training to be a professional ambulance officer. They will be trained and will be required to undertake further emergency medical training throughout their career. Once completed basic training, the trainees will be joining St John’s ambulance teams in Lae, Simbu and Port Moresby. It’s during this time they will do on-the-job training for 12 months. The two nurses from Manalos Aviation are being trained as Reservist Ambulance Nursing Officers to bolster primary air medical capability through the Manolos Mama Medevac program.
PACER Program to receive ongoing funding The ACT Emergency Services Agency announced that the Police, Ambulance and Clinician Early Response (PACER) initiative is set to receive further funding from the ACT Government, securing the team’s response every night for the next four years. PACER now has 29 highly trained first responders across the three agencies to call on for its daily 2pm to midnight shifts. For more information, visit: www.esa.act.gov.au
Camp Quality Wellington Free Ambulance Paramedics Tony and Andre enjoyed a fantastic day with the team at Camp Quality New Zealand, a charity focused on bringing fun, hope and happiness into the lives of children living with cancer. Alongside colleagues from NZ Police and Fire and Emergency NZ, the 60+ children had the chance to check out the different emergency vehicles, test the lights and siren, and go for a short ride.
Ambulance Victoria celebrates milestone with Tony Walker Ambulance Victoria CEO and CAA Board member Tony Walker celebrates 35 years in the ambulance sector, starting as a paramedic in 1986. Congratulations on this milestone Tony and thank you for all you have given to the ambulance sector.
Ferno branches out Ambulance, emergency, rescue and height safety supplier Ferno have extended their reach and announced the opening of Ferno New Zealand. A dedicated sales team comprising Brent Levy and Stefanie Meaclem will provide locally-based support to customers and partners in New Zealand. Brent is particularly excited to be home again in his native New Zealand, and brings a wealth of knowledge to his role as Territory Sales Manager. Ferno NZ will be fully supported by Ferno Australia under the management of Scott West.
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CAA First
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www.caa.net.au
Looking at the year ahead I’m always surprised at how much progress we see in our sector. How resilient our teams are even after surviving a global pandemic and extensive natural disasters, we look at how we can absorb, learn and grow the challenges that were presented to us. A big take away for me personally is the importance of looking after our teams, while they are incredibly resilient, we are now seeing the effects of a long-term disaster and the importance of looking after their health and wellbeing has never been more important.”
By Mojca Bizjak-Mikic
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W
ith COVID still holding on strong it continues to shift CAA’s plans. Sadly, we have been forced to yet again postpone our Congress by another year. We are now scheduled to see everyone mid-2022 in Sydney and will keep you regularly updated with our planning. But never fear our team doesn’t give up that easily and we have some exciting new initiatives to keep us busy this year. The first campaign of the year is in full swing with CAA recognising 60 incredible and inspirational women working across Australian, New Zealand and Papua New Guinea ambulance services. CAA2021 Women in Ambulance honour recipients show strength and commitment to the sector in their daily lives, and we are honoured that we get to recognise their hard work and dedication. The next few months will see a flurry of exciting panelstyle webinars under the CAA Webinar Series, kicking off with a Women in Leadership panel that will see top female leaders from ambulance, emergency and police share their career stories and discuss questions around gender equality and the role of female leaders in these sectors. In April we shine the light on pre-hospital stroke care, speaking to the recipients of to-date, the largest medical grant by the Australian Federal Government, the Australian Stroke Alliance who are working to revolutionise pre-hospital stroke care. May is our Hand Hygiene month and last year has proven that infection control and hand hygiene play a crucial part in preventing the spread of infections.
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We have invited our postponed Infection Control Forum speakers to share with you their thoughts on COVID, future pandemics, vaccine and everything else inbetween. June will see the launch of our new Virtual Expo, while we know we can’t really replicate the CAA Congress in a virtual setting, we wanted to bring the sector together in a fun 24/7 access Expo and share the latest developments, technology, products and innovations. Keep an eye out for free registration details. The second part of the year will bring our Mental Health & Wellbeing month with a focus on CAA’s new mental health and wellbeing app, Chnnl. We continue to raise awareness around cardiac arrest, CPR and AED use as part of the annual Restart a Heart Day in October, and in November we will get to celebrate the CAA2021 Awards for Excellence finalists and winners. In between our busy schedule, our Board, committees, forums and working groups have started work on delivering their 2021 objectives. The first round of meetings continues to be held online with hopes that we will be able to get together in person in the second part of the year. While video conferencing has proven a great new resource to keep in regular touch, we know sitting down together is where networking opportunities and sharing really excels.
www.caa.net.au
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CAA2021 Wo m e n I n Ambulance Awa r d s Congratulations to all our Honour Recipients and thank you for everything you do.
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n 2020, the Council of Ambulance Authorities was proud to launch the inaugural Women in Ambulance Awards designed to highlight successful and hardworking women in ambulance services across Australia, New Zealand and Papua New Guinea. This year, the CAA2021 Women in Ambulance Awards recognise 60 women for their work and career progression and are being championed as role models to the rest of the workforce.
The CAA Women in Ambulance Awards are looking to empower and inspire future generations of women to step into ambulance careers and progress into leadership roles and management levels.
NSW Ambulance
Alaine Burgess
Claudia Le
Dr Sarah Coombes
Kerry Trow
Michelle Shiach-Wise
Tanya Somani
Educator Communications
Employee Connect Coordinator
Executive Director Aeromedical Operations
Paramedic Specialist - Level 5 Intensive Care Paramedic
Paramedic 16 years service
Station Officer Laurieton Station
14 years service
32 Years service
12 years service
5 years service
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12.5 years service
www.caa.net.au
Ambulance Victoria
Caitlin Walker
Jacinta Roberts
Julie O’Brien
Dr Kate Cantwell
Michaela Malcolm
Sophie Faulkner
Senior Team Manager, Metropolitan Region
Senior People Partner
Area Manager, Metropolitan Region
MICA Paramedic & PhD, Operational Improvement Lead
HEMS MICA Flight Paramedic
Regional Capability and Development Coordinator
19 years service
21 years service
15 years service
18.5 years service
24 years service
14 years service
Queensland Ambulance Service
Ashleigh O’Kane
Carissa Owens
Chloe Bree
Emma McKenzie
Natasha Adams
Wendy Lowes
Advanced Care Paramedic II
Emergency Medical Dispatcher (EMD)
Senior Advanced Care Paramedic
Senior Operations Supervisor, EMU
12 years service
10 years service
Snr Critical Care Paramedic - High Acuity Response Unit (HARU)
Director, Human Resources Services
12 years service
11 years service
30 years service
13 years service
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St John WA
Caryn Hargrave
Chelsea Clinton-Burns
Jacqui Mackay
Leanne Hamilton
Natalie Whyte
Sally Simmonds
Transport Officer & EMT
Injury Support & Prevention Advisor
Station Manager & Paramedic
Ambulance Paramedic, Hospital Liason Manager
Quality Assurance Officer - State Operations Centre
Community Manager
16 years service
14 years service
16 years service
27 years service
7.5 years service
30 years service
SA Ambulance Service
Clare Toms
Dr Amy Keir
Kate Clarke
Leeann Faddoul
Nichole Bastian
Tori Butler
Operations Manager - Metre South
MedSTAR Kids Doctor
Operations Manager Clinical Hub
General Manager Infrastructure Procurement & Business Services
Operations Manager Emergency Operations Centre
Operations Manager - Mid North & Yorke
12 years service
16 years service
5 years service
15 years service
20 years service
23 years service
Ambulance Tasmania
Angela Hodgson
Helen Jenkinson
Kerryn Bone
Pam Woolnough
Samantha Allender
Sarah Pearce
Intensive Care Paramedic
Volunteer Ambulance Officer & Volunteer Unit Coordinator
Volunteer Ambulance Officer Level 3
Finance Officer
Project Manager, Secondary Triage
Paramedic & Peer Responder
16 years service
7 years service
32 years service
23 years service
40 years service
11 years service
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www.caa.net.au
As part of the CAA Women In Leadership Strategy, the Women In Ambulance Awards are designed to recognise inspirational women and their successful careers and also to promote them as the role models they are to the rest of the workforce.” Judith Barker, CEO, St John Ambulance Australia (NT) Inc
ACT Ambulance
Deirdre MacDonnell
Joanne Miles
Tania Thompson
Workforce Planning Team Leader
Intensive Care Paramedic
Executive Assistant to the Chief Officer
18 years service
12 years service
14 years service
St John Ambulance Australia (NT) Inc
Amy McCaffrey
Jana Lumsdon
Karen Hill
Nikki Trikilis
Serena Coleman
Stephanie Pilat
Paramedic
Communications Supervisor, ECC
Patient Transport Officer
Clinical Support Officer
5 year service
4 year service
12 years service
Executive Assistant to the CEO & the Board
ECC Training & Administration Support
4 years service
6 years service
4 years service
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St John New Zealand
Hannah MacLeod
Joelle Fox
Rosanne Shaw
Stacey Ayre
Susanne Doddrell
Clinical Innovation & Learning Manager
Territory Manager Buller, Tasman District
General Manager - Ambulance Operations
Centre Operations Manager
Double Crewing Project Lead
9 years service
16 years service
4 years service
8 years service
8 years service
Wellington Free Ambulance
Christine Galvin
Emily Wynch
Jec Sanders
Joan Bailey
Sarah Marsden
Yvonne Gemmell
Paramedic - Co Response Team
Improvement & Experience Manager
Consumer & Whānau Liaison
Project Analyst and Change Coordinator
Acting Blue Shift Manager, Healthcare Services
Patient Transfer Service Manager
18 years service
14 years service
20 years service
10 years service
9 years service
4.5 years service
St John Ambulance Papua New Guinea
Idana Enai
Phylmar Agarobe
Ruth Arongobia
Jacqueline Hennessy
Team Leader Aeromedical & Coordinator
Medical Call Taker & Dispatcher
1 year service
4 years service
Executive Assistant to Director Operation
Assistant CommissionerClinical & Operational Support 1 year service
3 years service
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www.caa.net.au
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Focus First
The Australian Stroke Alliance By Amanda Place
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he Australian Stroke Alliance brings together over 30 national agencies committed to transforming pre-hospital stroke care. This unique collaboration integrates clinical, academic, scientific, paramedical, consumer, commercial and philanthropic partners. This is a once-in-a-generation opportunity to address an unmet clinical need and to deliver urgent stroke care for all Australians. As one of the 30 agencies, the CAA is also an Essential Partner and member of the Alliance. The network of emergency ambulance services throughout Australia is represented by David Waters who is a member of the Alliance’s board. This partnership ensures that ambulance services, as the key provider of pre-hospital care can make a genuine contribution to the development and implementation of world-leading innovation in the early treatment of stroke. When a person experiences a stroke, every minute counts. First responders know that intervention in the Stroke Golden Hour can make a lifetime’s difference as brain cells begin to die. Fortunately, improved medications and surgical interventions have transformed stroke care in Australia in the last 20 years. We know that clot-busting drugs and surgical clot removal can stop the damage immediately – and the results can be quite extraordinary when delivered within the first few hours of the stroke. A unique collaboration is now ready to intervene to transform the way stroke is treated.
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This is a unique opportunity to develop a national standard in stroke care that will reach all Australians and transform care as we know it in Australia.” David Waters,
CEO, The Council of Ambulance Authorities www.caa.net.au
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Focus First
T
he opportunity can be compared to the revolution that took place in cardiac care – when thrombolysis was introduced into ambulances.
We know how to treat a stroke – but now we need to take the next step. We are ready to drive a technological revolution so we can take essential scanning equipment to the patient – in an ambulance – by road or air. Only then will paramedics and doctors be able to see inside the brain and identify the type of stroke. And then a true transformation can take place. Life-saving medication can be administered there and then. The beauty of this proposal is the capacity to take life-saving stroke care across vast distances to regional and remote parts of Australia – for the first time. The potential for global health impact is enormous. Lives will be saved. People will return to their productive lives. Inequitable access to world-class healthcare will be overcome.
Up, up and away… mobile brain scans to transform urgent stroke care . Work is underway to create world-first light, portable brain scanners so more Australians have rapid access to real-time stroke treatment. The radical approach will tackle the serious inequity of access to stroke care for rural and remote Australians. It is expected to dramatically reduce the risk of death and disability after a stroke. The Australian Stroke Alliance has received $40 million through the Frontier Health and Medical Research initiative. The five-year program will lay the foundations for a national and equitable approach to the treatment of stroke.
The work of the Australian Stroke Alliance will save lives with innovative tools, greater accessibility and improved clinical outcomes.”
Program co-chief investigators, Prof Geoffrey Donnan AO and Prof Stephen Davis AM, have welcomed the funding and promised a new era in stroke care, especially for the eight million people living in rural and remote communities, and for Indigenous Australians who suffer more strokes and typically, 10 years earlier than others. “Fundamentally, we are taking the emergency department to the patient, saving lives and preventing disability. And with new data showing a significant increase in younger Australians experiencing stroke, this will have enormous implications for the nation,” said neurologist Prof Geoffrey Donnan. Prof Davis added: “If you have a stroke in a remote part of Australia, you are twice as likely as city stroke survivors to be left with a serious, lifelong disability. And only three per cent of rural and remote patients receive care in a specialist stroke unit, compared with 77 per cent of people in metro areas”. “We are bringing together the Royal Flying Doctor Service, aeromedical and material engineers, stroke physicians, Indigenous medical professionals, specialist nurses and paramedics, as part of a revved-up team of more than 30 organisations,” he said. The research program encapsulates a wide range of world-first initiatives including two light, portable brain scanners, locally designed and built to suit different forms of emergency transport – by road, helicopter or fixed-wing ambulance. As well, the world’s first stroke patient app will use a novel digital telehealth platform to transfer and receive real-time patient scan, video and audio communication with a city-based stroke physician, 24-hours a day, transforming the support of health carers out in the field. Key Alliance members, Royal Melbourne Hospital and Ambulance Victoria, have already delivered Australia’s first mobile stroke road ambulance, which Ambulance Victoria operates within a 20km radius of the Royal Melbourne Hospital. It has cut treatment time by 41minutes and treated 10 times as many patients in the first ‘golden hour’ after stroke, enabling a rapid diagnosis and life-changing treatment to be delivered faster than a traditional transfer to hospital.
Professor Steve Davis
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www.caa.net.au
The Stroke Golden Hour We are excited to announce that the Australian Stroke Alliance has received $40 million from the Frontier Health and Medical Research initiative. We would like to thank the MRFF and the Federal Minister for Health Greg Hunt for investing in innovative stroke care. “This funding will mean the Australian Stroke Alliance will be able to accelerate the development of new technologies to reach patients earlier, treat stroke faster and to improve recovery of the Australians who suffer a stroke.” - Professor Geoffrey Donnan
The Mobile Stroke Unit is delivering fantastic results for those with stroke in metropolitan Melbourne. We now need to do much more, much better for those in remote and rural Australia.” Mick Stephenson ,
Executive Director Clinical Operations, Ambulance Victoria
The Australian Stroke Alliance is now empowered to deliver new technologies that will improve diagnosis, treatment times and post-stroke care for all Australians, no matter their postcode. “This grant will help Australia to become the global leader in transforming stroke care and in new imaging technologies, materials manufacturing and software engineering. The impact of this work won’t only be felt here in Australia, but around the world.” - Damien Easton CEO, Australian Stroke Alliance We are proud to be working with an incredibly diverse, passionate and dedicated team across this country to improve the lives of stroke patients.
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There are multiple issues which are stopping a more positive outcome for victims of cardiac arrest but they can be linked back to three major factors, namely time, lack of collaboration & leadership and technology.” Julie Hughes Executive Director, Michael Hughes Foundation
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www.caa.net.au
Why should we invest in HeartSafe Communities? by Julie Hughes
S
urvival rates in Australia of cardiac arrest are disgustingly low – less than 10% of those who have a cardiac arrest outside of hospital will survive. Literally thousands of individuals are losing their life unnecessarily. What are we doing wrong? In Australia, we have high-quality healthcare and emergency response systems as well as world leading Cardiologists and medical professionals – supported by advanced medical technology. State and Local Government agencies are supporting the increased first aid response of their communities by investing in defibrillators through various grant funding and within certain sectors – NSW Office of Sport has part funded over 1,500 defibrillators to sports clubs across NSW over the past three years. Defibrillator and first aid providers are actively (and competitively) working to increase the medical response of individuals in Australia whilst supporting the Call Push Shock messaging of Restart a Heart Day! The community, our biggest resource in the response to cardiac arrest, is seeing momentum towards increased knowledge of the signs of cardiac arrest (unconscious and not breathing) and investing more in first aid training and in lifesaving defibrillators for their communities. With personalities like the Yellow Wiggle Greg Page and Rugby League great Gary Jack both suffering a cardiac arrest, it hits home to the realities that it can happen to anyone and at any time.
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There is so much activity within this country focussed on cardiac arrest but survival rates remain staggeringly low, at the same level when Kerry Packer suffered a cardiac arrest whilst playing polo in the early 1990s. This is even after his financial support to the NSW State Government for defibrillators for every Ambulance in the State (they were commonly referred to as the Packer Wackers). There are multiple issues which are stopping a more positive outcome for victims of cardiac arrest but they can be linked back to three major factors, namely time, lack of collaboration & leadership and technology.
Our Foundation will continue our commitment to this health issue and to the development of HeartSafe Communities.
So what is the answer? The response to cardiac arrest is extremely fragmented. HeartSafe Communities is a framework that can be implemented and “Australianised” to provide solutions and like the Cardiac Chain of Survival, creates a team effort. It focusses on all aspects of the response required… not just one part. It is being implemented sporadically across Australia and in most cases, by passionate individuals who have seen a need to act. By developing programs based on the HeartSafe Communities framework: Time can be dramatically decreased by enabling better communication channels for bystanders to act quickly – i.e. recognise a cardiac arrest, call 000, commence CPR and access and utilise available defibrillators that are in residential, commercial and community spaces. Collaboration can be increased. All programs must be supported by the Government and linked to Ambulance services in each state. We require leadership and collaboration at a state government level to implement a holistic approach and bring all parties together for a common pathway. States themselves can learn from each other and foster a national approach. Technology systems can be implemented to support the process of a medical response. Technology can increase communication channels, registration and mapping of existing defibrillators, provide links to 000 operators and provide valuable support to bystanders and victims of cardiac arrest. Technology and data can be used for ongoing developments and improvement processes.
Unfortunately, there is no simple answer or silver bullet! We know that all strategies require a long focus for improvement. As a Foundation, we are utilising internationally recognised frameworks and implementing them locally. We recognise the benefits of our community engagement initiatives and working at a State level. We are hands on and we take great learnings from all individuals we meet. Our training and education services increase knowledge and confidence and although it is labour intensive, we know the long-term benefits. Our Foundation is very clear on our mission and vision in New South Wales and we strongly advocate for: •
Government frameworks to support communities respond to cardiac arrest.
•
Registration of defibrillators for increased access and support for maintenance
•
Good Sam technology for increased communication and response strategies
•
Enhancing the abilities and links to NSW Ambulance for all initiatives
•
Creating minimum Australian standards to be set on HeartSafe Communities.
Our Foundation will continue our commitment to this health issue and to the development of HeartSafe Communities. We are proud of our collaborations and to be focussed on finding solutions to the issues that matter.
Julie Hughes Executive Director, Michael Hughes Foundation Julie is a Founding Director of the Michael Hughes Foundation, a social enterprise created as a legacy for her husband, Michael. Julie was the first responder to her husband’s cardiac arrest in 2013 and is a passionate advocate for increasing survival rates of cardiac arrest in NSW. The Michael Hughes Foundation is developing HeartSafe communities in Melrose Park and City of Parramatta Council. Julie is a member of the NSW Health Expert Group – Prevention of Premature Cardiac Mortality
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Services First
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St John WA’s winning Pride GLAM-bulance a hit From St John WA
St John WA has a colourful addition to the fleet with a new glammed-up ambulance to support WA’s LGBTQI+ community.
D
ubbed a “GLAM-bulance”, the decommissioned ambulance was covered in an eye-catching design by local WA artist Nathan Richards who took out the top spot in the 2020 St John WA GLAM-bulance competition.
Nathan said the design was inspired by St John WA’s message ‘for the service of humanity and equality which signifies inclusivity and equal representation. Starring eight characters, entwined with colours from Daniel Quasar’s progressive pride flag, Nathan’s design pays homage to WA’s diverse community.
St John WA’s Facebook competition was held last November, following the cancellation of the 2020 PrideFEST. Users were encouraged to submit pridethemed ambulance designs in support of WA’s LGBTQI+ community, with one creative winner having their design brought to life by St John WA. After making it through to be one of the five finalists, Nathan’s design won the competition through a public vote, securing an incredible 1,577 votes. The ambulance has now been wrapped with Nathan’s design by Jason SignMakers, who donated their services to wrap the vehicle. A Melville based artist, Nathan (Paper Wombat) saw St John WA’s GLAM-bulance competition as the perfect opportunity to contribute to supporting the LGBTQI+ community. He felt that even though he couldn’t celebrate the annual festival, he wanted to bring Pride to Perth.
Over the last two years, St John WA has participated in the PrideFEST parade with its own extravagant ‘GLAM-bulance’, designed by an internal graphic designer. This year, for the first time, the opportunity was extended to the entire WA community. St John WA CEO, Michelle Fyfe said the GLAM-bulance competition has provided the perfect platform for the Western Australian community to come together and celebrate as one. “We’re so proud to be able to support the LGBTQI+ community, as well as Perth’s brightest artists.
Nathan Richards. chelle Fyfe and artist St John WA CEO Mi
“St John WA plays such a vital role in our community. Both the paramedics and volunteers deserve so much recognition for the work they do, saving lives and caring for our most vulnerable.” “It’s very special to have my design selected for the GLAM-bulance. Together, we can share an important message of equality and inclusion; no matter how you identify, you are welcome and are a valid member of our community,” says Nathan.
Nathan’s design is abundant with joy and positivity and will bring a ray of light to the streets of Perth,” says Michelle. Perth’s most colourful ambulance will be hitting the road for a Pridethemed road trip all the way to the top of our state for Broome Mardi Gras from the 24th – 28th February. St John WA is committed to equality, proudly supporting the LGBTQI+ community as part of its ongoing commitment to diversity and inclusion.
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Services First
New St John WA sub centre in York marks end of fire recovery From St John WA
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t John WA’s new state-of-the-art sub centre and first aid training facility in York is now in operation, four years after being gutted by fire.
The original building was constructed in 1985 and was badly damaged by fire in 2016, resulting in a need to demolish the structure and undertake a total rebuild. Two ambulances were also destroyed at the York depot. The new building was officially opened during intrastate travel restrictions in Western Australia which remained in place following a snap week-long lockdown to respond to a potential COVID-19 outbreak. As a result, key personnel attended the opening via videoconference. St John WA Head of Country Operations Justin Fonte said York staff and volunteers, whose efforts ensured the facility now has a dedicated space to undertake on-site ambulance and first aid training. “Our previous facility was a little tired and was lacking modern features, so this new building is a welcome improvement,” Mr. Fonte said With two dedicated training areas, we will be able to hold more training for ambulance volunteers and train more members of the public in CPR and first aid, building a safer and more resilient community.
“The $800,000 project was made possible thanks to the hard work of local staff and volunteers.” The sub centre has a fully functional kitchen, dining furniture all the way down to cookware, appliances, crockery, cutlery, and utensils. Mr. Fonte said the new fixtures will allow ambulance volunteers to relax and debrief after attending to callouts in the local community. “St John WA York carries out over 500 jobs per year with about 16 active volunteers.” “This project will have a positive benefit for the community as we will be able to conduct more training courses and be better equipped to help more people.” The York sub centre also received funding from the Australian Government through the Stronger Communities grants program and from the Department of Social Services through the Volunteer Grants Program.
Inset: Key personnel attended the opening via video conference to accommodate COVID-19 related travel restrictions.
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Opposite: The new York sub centre.
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ntre was The Y or k subtecde by f ire in 2016. gut
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Services First
Northern Territory takes on Co-Response approach for mental health From St John Ambulance Australia (NT) Inc
When the St John NT Project Leader, Duty Manager Nicole Johnston called for expressions of interest in a new multidisciplinary approach to mental health patients, she knew that there would be genuine interest from Darwin-based paramedics. “This was an opportunity for them to extend their scope of practice, an opportunity to learn more about managing patients suffering an acute mental health crisis and increase their level of skill and exposure to mental health patients.” And what was it that had garnered their interest? St John NT has joined with NT Police and NT Department of Health clinicians to provide a new, collaborative approach to
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mental health emergencies in the Top End, known as Co-Response. Initially set up as a six-month pilot, Co-Response provides a specialised team consisting of a mental health clinician, a police officer, and a paramedic to respond to Triple Zero (000) calls for acute mental health crises in Darwin and surrounding areas. While Johnston is the first to admit that this is not a new approach, it is new for the Territory. Many other jurisdictions have developed a Co-Response, PACER (Police, Ambulance and Clinical Early Response), or similar program designed to suit their demographics and resources.
Feature Image: A mental health patient receiving care from St John NT. Inset: Co-Response Project leader Nicole Johnston
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The Co-Response program aims to manage patients in their own environment to reduce mental health Emergency Department admissions and to improve experiences and reduce trauma to individuals suffering an acute mental health episode. Further benefits of the program include patient-centred and specialist care, improved patient outcomes, rapid access to mental health intervention, and avoiding restrictions of freedom to individuals (Policy Custody and Sectioning). The Territory pilot operates five days a week, Monday to Friday from midday to 8pm. The CoResponse specialist team includes four members of NT Police, four trained paramedics from St John NT, and two clinicians from Top End Mental Health Alcohol and Other Drugs Service (TEMHAODS). The team is located at a Darwin Police Station. Calls to the service are taken and managed by St John NT in its Emergency Communication Centre, and the team travels in a St John NT branded ambulance. “The need for Co-Response to operate from a St John NT ambulance was overwhelming,” she says. “It was identified very early on in the planning that St John NT is seen by the community to be trusted and supportive. We have utilised a vehicle that is very well identified as St John NT. We want to reassure patients that the response they are being provided is about health care, not law enforcement. Each of the team members has a specific role to play, from doing a risk assessment to ensure the safety of the team, patient and bystanders; identifying and treating illness and injury; through to the mental health assessment and appropriate treatment.” “Safety is the first priority for everyone,” she said.
More than halfway through the pilot, Johnston says that the results have been very promising. “The key focus of this is patient care. Whether the trial has been successful or not could be measured by our ability to provide someone
“Additionally, by having a specific team available to manage mental health cases, we are enabling our ambulance service to respond to emergency situations more effectively.” Another key aspect to having the multidisciplinary team is its ability to information share. Whereas generally, the three services would normally operate from their own data on a particular patient, by working together they are able to share information and build a more holistic understanding and care for the patient.
“This approach also helps us outside of the Co-Response operating hours. We are now much better educated on the particular needs or St John NT circumstance of a patient Images supplied by because of what we have experiencing an acute gathered through Co-Response, and mental health crisis with someone it assists in our ambulance service to who can provide them with provide a consistent approach to the specialist mental health support.” patient.” “The second most important As the Project Leader, Johnston aspect, after the tailored mental hopes the program continues past health care, for us is knowing that the six-month pilot period. we have been able to leave the patient in the community, that they “We know that Co-Response is a haven’t had to attend an Emergency positive step towards providing Department and potentially be an opportunity for mental health admitted to hospital.” patients to receive targeted health care, to stay in an environment “Of all the cases that the they trust, and have greater access Co-Response team has attended to mental health information and so far, at least half of the patients services in the Top End.” have been able to remain in the community. For these patients, if they had gone to hospital, it may have increased their trauma during their mental health crisis. Being able to keep patients in an environment that is familiar to them, with the people they know and feel comfortable with is so important.” The pilot has responded to an average of 30 - 40 calls a month. Of these, more than half of the cases attended did not require admission to hospital.
I knew this would open up opportunities for paramedics to do something different, that they would jump at it, that this was something paramedics would want to do.”
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Services First
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www.caa.net.au
Getting to the core of mental health problems From SA Ambulance Service
SA Ambulance Service is helping mental health patients avoid the hospital emergency department by partnering paramedics with mental health nurses.
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he Mental Health CoResponder program (MH CORE) has proven successful in navigating mental health patients to community-based care and is being expanded across the Adelaide metropolitan area. MH CORE responds to low acuity mental health cases including selfharm, suicidal thoughts, anxiety, depression, exacerbation of a mental health issue or a situational crisis.
The following comment from a MH CORE patient illustrates why alternate pathways like MH CORE are so valuable. “I find it traumatising going to the hospital… security guards and the sounds of the ED are too overwhelming, but having someone to talk to in my own environment calmed me down immensely. I would have had much fewer hospital visits or even suicide attempts if MH CORE was a thing before.”
Three-quarters of the people seen by MH CORE crews in 2020 were supported with home or community-based care, whereas previously most would have been taken to an emergency department. Emily Leadbeater is a SAAS paramedic who has worked regularly on MH CORE crews with mental health nurse, Kathryn Beharrie from Central Adelaide Local Health Network. “When we first attend, we’re able to de-escalate the situation and provide crisis intervention and care,” explains Emily. “Then we sit down with them and go through the communitybased care that they have available, and we also do reviews and followup calls to make sure that’s been successful for them.”
For most of 2020, there was one MH CORE crew operating five days a week on eight-hour shifts. They were tasked to 400 cases, and after accounting for 57 people who could not be located on arrival, they assisted 343 people. Only 80 of those were taken to an ED, including 14 for medical reasons.
MH CORE crews use a light vehicle rather than an emergency ambulance, and are able to transport some patients to community-based care or an ED. In fact, almost onethird of those who needed to go to ED were able to be taken by the MH CORE crew which is less distressing than an ambulance transfer and also leaves more emergency crews available in the community. MH CORE has been granted funding for a fivemonth expansion of the program, with three crews operating seven days a week on 12-hour shifts through partnerships between SAAS and the Central, Southern and Northern Adelaide Local Health Networks. In addition to the metropolitan MH CORE service, SAAS is also partnering with the Yorke and Northern Local Health Network on a service in Port Pirie where a mental health nurse consultant can join SAAS crews onscene to help with de-escalation and assessment, and take handover of the patient to arrange their care.
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Awards First
CAA Awards for Excellence 2019 Category Winners
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www.caa.net.au
W
e are excited that we get to bring back the CAA coveted Awards for Excellence in 2021. As you know last year due to COVID demand we chose to postpone the CAA Awards, a first since their debut in 2007.
2021 brings with it the return of the awards and also a brand-new category Excellence in Mental Health and Wellbeing.
CAA2021 Awards for Excellence categories include:
The CAA Awards online platform is open to entries and some of the key dates to remember are:
Excellence in Clinical Practice (innovation or capability)
4 June 2021 – Awards deadline
Excellence in Technology (innovation or capability)
Excellence in Staff Development (education improvement or innovation)
16 July 2021 – Judging closes
Excellence in Patient Care (patient experience improvement or innovation)
10 August 2021 – CAA2021 Awards Finalists announced
Excellence in Leadership (management practice and operational improvement and innovation)
November 2021 (exact date TBC) – CAA Awards Gala Dinner, Sydney
Excellence in Mental Health and Wellbeing (innovation or operational improvement)
To get you inspired and showcase our past winners we are today highlighting two category winners from CAA2019 Awards for Excellence
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Awards First
Excellence in Leadership SA Ambulance Service Reconciliation Action Plan (RAP) SA Ambulance Service (SAAS) embarked on the Reconciliation Action Plan (RAP) to engage with Aboriginal and Torres Strait Islander (ATSI) peoples, increase their current rate of employment in its workforce and deliver equality of healthcare thereby making a positive contribution to Closing the Gap. A range of initiatives highlighted within the SAAS first RAP include:
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Provision of cultural training programs for staff
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Opportunities for staff to engage with Aboriginal and Torres Strait Islander communities by participating in locally based cultural events
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Building key performance indicators into performance reviews to encourage staff to contribute to reconciliation
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Reward and recognise silent achievers who contribute to reconciliation
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Using culturally appropriate artwork to promote commitment to reconciliation
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Cultural mentoring network for existing Aboriginal staff
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Implementing employment pathways such as traineeships specifically for Aboriginal peoples
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Implementing a recruitment and retention strategy through the broader SA Health Aboriginal Workforce Implementation Group
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Identifying opportunities to support existing health services meet the health needs of local Aboriginal communities
Aim RAP is a framework designed to contribute to reconciliation and improve the health and wellbeing of Aboriginal and Torres Strait Islander communities. Following the Reconciliation Australia RAP guidelines, the SAAS RAP identified three main areas to address: 1. Introduce all staff to the purpose of the RAP 2. Educate all staff in the history, culture and spirituality of Aboriginal and Torres Strait Islander peoples 3. Engage and empower staff to seek out opportunities that have a direct impact on improving Aboriginal people’s health outcomes.
Background Health is a holistic term for Aboriginal people encompassing their physical and mental health, employment, education and living standards. For them, hospitals may be seen as a place with negative connotations associated with suffering and death; when English is not their first language, they are often reluctant to engage in conversations that reflect negative health outcomes; their spiritual and cultural beliefs can conflict with western medicine. Ambulance services have the opportunity to break those barriers and engage in respectful relationships and build trust as they travel into communities.
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Implementation
Evaluation
The project began in 2016 with a committee of 12 staff members recruited from across the workforce, including operational and non-operational, career and volunteer, Aboriginal and non-Aboriginal staff, in both the metropolitan and country regions.
Paramedics now perform regular health checks and oversee distribution of medications for clients from surrounding communities of Yalata, Oak Valley and other APY communities.
During development of the RAP, the committee participated in Aboriginal community events to inform their path and lead the organisation to effectively work with Aboriginal communities, build relationships and an understanding of Aboriginal culture, history and spirituality. A major challenge was acknowledging that Aboriginal Australians do not identify English as their first language along with staff acceptance of the RAP due to a range of personal values, believes and experiences. The official launch in May 2018 was professionally filmed to create a 20 minute video, which has been incorporated into training sessions to ensure the same information and key messages are seen and heard by all staff. Staff must also complete a one hour Aboriginal cultural awareness e-learning package.
Aboriginal artwork commissioned to adorn the livery of community paramedics’ vehicles in Ceduna where 22.4 per cent of the community identify as Aboriginal and Torres Strait Islander, has been a successful initiative to build trust with a universal language. The strength of the relationships, respect and trust developed has enabled paramedics to provide early interventions, hospital avoidance and follow up checks with clients who visit the Aboriginal Drug and Alcohol Council (ADAC) clinic. Paramedics are empowering clients to look after their healthcare. Community paramedics’ work in Ceduna is an excellent example of a RAP actively contributing to better healthcare outcomes for Aboriginal communities.
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Awards First
Excellence in Clinical Practice Ambulance Victoria A state-wide, multi-agency model for High Performance CPR
Developing and implementing a model for AV and external Emergency Medical Responder (EMR) partners, the Metropolitan Fire Brigade (MFB) and Country Fire Authority (CFA), was a significant undertaking given Victoria’s population and the size of the combined workforce.
More than 30,000 Out of Hospital Cardiac Arrests occur across Australia and New Zealand annually and typically less than 10 per cent survive, with similar rates of mortality globally.
While Ambulance Victoria is a regional leader in OHCA outcomes, there is considerable variation across geographical regions and agencies.
When effective cardiopulmonary resuscitation (CPR) and defibrillation are provided quickly, the chance of successful resuscitation greatly increases. A ground-breaking 10 step program to improve Out of Hospital Cardiac Arrest (OHCA), approved by Emergency Medical Services (EMS) leaders comprising the Global Resuscitation Alliance (GRA), has the potential to improve survival by up to 50 per cent. While Ambulance Victoria (AV) is committed to adopting each step, two programs were identified as the most significant for patient survival in Victoria. •
Begin high-performance CPR (HP CPR) with ongoing training and quality improvement
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Measure professional resuscitation using the defibrillator recording.
The overall aim of the project was to improve the resuscitation skills of EMS in Victoria, particularly chest compression fraction, rate and depth and in the long term improve the rate of OHCA survival in Victoria.
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After decades of resuscitation research, high-quality CPR has emerged as a critical factor for survivability. The American Heart Association (AHA) guidelines, International Liaison Committee on Resuscitation (ILCOR) guidelines and the Australian and New Zealand Committee on Resuscitation (ANZCOR) guidelines repeatedly emphasise the importance of high-quality CPR with minimal interruptions as the basis for optimal resuscitation.
Methodology An AV CPR Feedback Pads Trial in 2017, which analysed approximately 80 resuscitation attempts, revealed that adequate compression depth and rate were achieved only 50 per cent of the time; the average pre-shock pause was 16 seconds; and an adequate chest compression fraction was only achieved 65 per cent of the time.
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Consistent interruptions greater than five seconds can reduce a patient’s chance of survival by up to 18 per cent. While pauses are necessary for ECG rhythm analysis, specifically pre-shock pauses prior to defibrillation, extended pauses can decrease the chance of survival. A retrospective analysis of over 14,500 OHCA in Victoria showed: semi-automatic rhythm analysis removed human performance variability and led to quicker initial time to defibrillation but resulted in reduced incidence of event patient survival and survival to hospital discharge. Performing hands-on charging and analysing the ECG rhythm in manual mode, combined with a well-choreographed, ‘pitcrew’ approach to the rhythm analysis and responder rotation can significantly decrease CPR interruption.
and share success stories, and an intranet page housing updated guidelines, instructional videos another other new resources. AV also collaborated with the MFB and CFA to incorporate HP CPR for first responders; and the university sector to provide training and resources linked to accredited paramedic undergraduate programs. Now, University students on clinical placement are trained and practised in AVs HP CPR model.
The Resuscitation Officer worked with leaders in resuscitation improvement in what is believed to be the first joint effort to improve OCHA in Performing hands-on charging Australia and New and analysing the ECG rhythm in Zealand.
manual mode, combined with a well-choreographed, ‘pit-crew’ approach to the rhythm analysis and responder rotation can significantly decrease CPR interruption.
Implementation A Resuscitation Officer was appointed in 2018 as part of the Research and Evaluation Team, to lead the development and implementation of the model, and introduce systems to support data collection and the debriefing model. New cardiac arrest guidelines were approved and a HP CPR education package was developed, combining eLearning modules, didactic teaching and simulationbased training. These initiatives were supported by interactive Workplace groups to answer staff questions
HP CPR became expected practice from 11 February, 2019.
Evaluation
It is anticipated that the realtime audio-visual feedback provided through CPR feedback pads during resuscitation attempts, combined with ongoing training in HP CPR and structured debriefing will result in the delivery of high-quality CPR and improved patient outcomes.
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Congratulations
to all CAA2019 Awards For Excellence Winners
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www.caa.net.au
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Feature First
D Dame Patsy Reddy
Governor-General of New Zealand Her Excellency The Right Honourable Dame Patsy Reddy was sworn in as New Zealand’s 21st Governor-General for a five year team on 14 September 2016. Dame Patsy is very keen on arts and culture – particularly film, opera and visual arts.
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Feature First
D
ame Patsy Reddy was born in Matamata, New Zealand and completed her law degree from Victoria University of Wellington. She joined the law firm Watts and Patterson (now Minter Ellison Rudd Watts) in 1982, and became the first female partner in 1983, specialising in tax, corporate and film law. In 1987 she joined Brierley Investments Ltd as Group Legal Counsel and subsequently became Group Manager for Special Projects, where she was involved in numerous mergers and acquisitions, including the privatisation and subsequent flotation of Air New Zealand, and the construction, establishment and flotation of Sky City Entertainment Ltd. Following an illustrious career in law and investment, she made the move to the public sector and was appointed to Governor-General of New Zealand in 2016.
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Feature First
W
e had the distinguished honour of speaking to the Rt Hon Dame Reddy in the lead up to 2021 International Women’s Day, wanting to get insight into her career and hear her thoughts on the progress of women in leadership roles. F. Dame Patsy, you have had a distinguished career and have risen to the top of the industry; if you had to choose, what would you consider to be a couple of your most celebrated achievements? I don’t believe in looking back so I don’t really have an answer to this question. For me, it’s more important to focus on the present and plan for the future. Now that I have more yesterdays than tomorrows I have to make sure they all count!
But whatever their gender, it is always an advantage to understand your colleagues’ strengths and weaknesses, and their interests. I think it’s much easier to succeed if you are prepared to listen and allow others to succeed too. Being a team player is essential, even when you’re the boss.
F. Looking back at your career, what were some of the key decisions you made that helped push you forward and succeed in your field?
F. For our women reading today, what advice would you give to grow their careers?
I think that the important decisions for me involved taking risks. Not crazy risks, but being prepared to try new challenges that took me out of my comfort zone. It’s frequently observed that women are more cautious about putting themselves forward for new roles or career changes. I was no different, so I didn’t find it easy. So, having achieved a partnership (the first woman partner) in my law firm, I decided to resign after three years and join an investment company when an opportunity arose. After around 20 years of working in various roles in the private sector, I decided to leave and take on governance and consulting roles in the public sector. In both cases I wasn’t confident in my ability to make the shift but I knew that I would regret it if I didn’t try. F. We know that as much as times are changing and gender balance is progressing, there is still much to do in this space. As a powerful woman working in different industries throughout your career, what were some of the lessons you learned on the way? When I first started in business in the 1980s, I was frequently the only female in workplace meetings and negotiations, and I soon realised the easiest approach was to adopt the style and interests of the men I was working with. I didn’t want to appear different or threatening. I learnt to understand the interests of my male colleagues so that I could participate in discussions about sport (for instance, I learnt the finer points of rugby and cricket and even followed the Formula 1 seasons). I didn’t seek to engage them in discussion of my own interests such as performing arts and fashion, unless they initiated it.
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I must say that fortunately, times have changed and women are generally now able to be more comfortable in their own skins.
Be prepared to analyse your own strengths and weaknesses and work with them. Listen to advice but remember that in the end you are responsible for the choices you make. Be prepared to challenge yourself and accept new opportunities even if they are outside your own comfort zone. It’s hard to grow your career if you keep doing the same thing. I am not so sure it’s possible to be superwoman – to have it all at once. I feel it is important to set your own priorities and remember that if you find you’re unhappy in your career, you should not feel afraid to change it. We all make mistakes. The key is to make sure we learn from them. F. We hear a lot about the importance of having mentors and sponsors. What are your thoughts and experience? When I studied law and then joined the workforce, there weren’t mentors or sponsors as such. But I knew instinctively that I only wanted to work for bosses I respected and who treated me fairly. While that wasn’t always easy and I certainly came across my fair share of colleagues who didn’t meet those expectations, I was lucky to find some who supported me and made a real difference to my career opportunities. They became my de facto mentors though they never formally assumed that role. In today’s working environment I think mentors can be very valuable, as can business coaches. I also recommend making use of networking opportunities and organisations.
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F. What are some of the changes you would like to see in the future for more balanced workplaces, not only for gender but for other marginalised groups? I’ve come to the view that we should have minimum quotas for women in governance roles in public listed companies and public sector boards. We’ve spent far too long waiting for the “pipeline” to produce gender equality and it simply isn’t working fast enough. Similarly all public sector organisations and listed companies should be expected to adopt a diversity policy and report against it annually to their stakeholders. Having to explain a lack of diversity is a good way of forcing businesses to focus on the issues. And the gender pay gap should also be publicly disclosed, each year. Wherever possible, shareholders, customers and clients should ‘walk the talk’ and be prepared to hold businesses to account on these measures. F. We imagine working as a busy lawyer is quite different to the Governor-General’s role; what do your days look like and what are your favourite parts? Actually, I haven’t practised as a lawyer for nearly 30 years (one of the career changes I made!). The Governor-General role is so different to anything else I’ve ever done. Initially it certainly took me way outside my comfort zone! It is a real privilege to hold the position and represent our nation’s Head of State. I get huge satisfaction from celebrating the success of New Zealanders, whether it’s at investitures or youth awards or sports or arts events. I am patron of around 140 different charities and not-for-profit organisations.
I get to showcase and commemorate important events, both domestically and internationally, and I lead the nation at times of national mourning. We also hold many receptions, particularly for my patronages, and I deliver lots of speeches! When I began my term I set out a strategic plan with some areas I wished to prioritise in my community engagement: creativity, innovation, leadership and diversity. I have attempted to focus on and showcase these areas throughout my term. F. What are some of your most memorable experiences since becoming the New Zealand Governor-General? One of the most significant moments for me was meeting the Queen and Prince Philip at Buckingham Palace, the first time in 2016 before I took up the Governor-General role. It was truly awe-inspiring, not only because of the location but also thinking about just how many people Queen Elizabeth has met over her long reign. She must surely be the most famous person in the world. There have been some significant international events, such as opening the New Zealand Pavilion at the Venice Biennale, several WW100 commemorations and some State Visits. Of course, the last 12 months have been very different, due to our pandemic border lockdown. But I’ve still had the opportunity to visit many regions right across Aotearoa New Zealand and meet many thousands of New Zealanders of all ages and from all walks of life. It’s an experience I’ll always treasure.
Image provided by Bay of Plenty Times photograph by George Novak
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Events First
T
he CAA Webinar Series is designed to inspire and educate with a range of speakers discussing topical issues from around the ambulance world.
These one-hour long webinars were originally devised to fill a gap left behind from postponing our CAA2020 Congress due to COVID-19 restrictions, but due to their success, they are now a permanent initiative of CAA. The webinars are free to attend and registered paramedics can claim CPD points for attendance to contribute to their ongoing professional development. We look forward to you joining us! For more information on the CAA Webinar Series, past recordings and to register for upcoming sessions visit: www.caa.net.au/webinars
Previous Webinars A glance back at our most recent events
Cyber Security Tuesday 23 February 2021 Did you know that healthcare data is more valuable than financial data on the black market? Or that it is estimated that cyber attacks make more money than the drug trade? You may have heard of phishing, but how about smishing and vishing? Cyber attacks and scams are an unfortunate reality, and staying safe online has never been more important. This webinar was an eye-opening look into the world of cybercrime and the many ways that these criminals can steal personal data or scam unwitting people, and the best practice and programs to stay safe online.
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Dan Weis – Cyber Security Expert Dan has so many IT industry qualifications, his nickname is The General. In fact, he was one of the first 10 people in the world to become a Certified Ethical Hacker. Thankfully, he’s one of the good guys. Dan works to proactively assess company and government networks to increase their security protocols. With over 25 years experience in I.T, he works to educate people on the risks of cyber crime, cyber-attacks and threats and the dark web. In addition to his role at Nexon, Dan undertakes research on the cybercrime underground, facilitates training sessions for budding ethical hackers, is a regular on the speaker circuit, has a number of published resources including books, magazine articles, newspaper appearances, online posts and Youtube videos, and is an active participant in a variety of renowned security and industry programs.
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Women in Leadership Panel Tuesday 23rd March 2021 CAA is dedicated to improving the gender balance across the ambulance sector through our Women in Leadership Strategy and Working Group, and the Women in Ambulance Awards. In this webinar, three inspiring female leaders from the emergency services sector shared their story and advice for the next generation of leaders, before joining us for a live panel interview. This webinar recording is available to view on The Council of Ambulance Authorities Youtube
Judith Barker – CEO, St John Ambulance Australia (NT) Inc. As the CEO of St John Ambulance Australia (NT) Inc. Judith has more than 20 years of leadership and clinical experience within the ambulance industry having been appointed to a diverse range of positions across multiple ambulance services. Judith is passionate about ambulance and the positive impact it can have on the health of a community through innovative service delivery. Judith started her career in ambulance in 1997 as a paramedic with St John WA, moving to SA Ambulance Service (SAAS) in 2003. Over the following 16 years with SAAS she progressed through various clinical and management roles.
Georgeina Whelan – Commissioner, ACT Emergency Services Agency Georgeina joined the ACT Emergency Services Agency as the Chief Officer of the State Emergency Service in late October 2017 having completed 32 years of military service. She was appointed as the Commissioner of the ACT Emergency Services Agency in September 2019. Georgeina was awarded a Conspicuous Service Cross (CSC) in 2004 and was made a Member of the Order of Australia (AM) in 2006 and a Bar to her Conspicuous Service Cross in the 2016 Queens Birthday Honours List. She was named ACT Telstra Business Woman of the year in 2015. She holds post graduate qualifications in Business Management, and Defence and Strategic Studies.
Tracy Linford – Deputy Commissioner (Crime, CounterTerrorism and Specialist Operations), Queensland Police Service Deputy Commissioner Tracy Linford APM has over 36 years’ experience in both the Victorian Police and the Queensland Police Service. In December 2017, she was promoted to Deputy Commissioner at the Queensland Police Service and currently holds executive responsibility for the Crime, Counter Terrorism and Specialist Operations portfolio. Deputy Commissioner Linford holds a Bachelor of Business Management Degree and an Executive Masters in Public Administration. In 2009 she won an outstanding leadership award from ACWAP for driving cultural change. She was awarded an APM in the Australia Day Honours in 2014.
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Events First
Upcoming Webinars Join us for our next sessions
The Future of Stroke in Pre-Hospital Care Thursday 29th April 2021 A panel of experts from the Australian Stroke Alliance will share an update on pre-hospital stroke care, including current best practice guidelines, and an update on “the Golden Hour” grant, which will deliver new technologies that will improve diagnosis, treatment times, and post-stroke care. Speaking during this webinar are Professor Geoffrey Donnan AO, Professor Steve Davis, Sharon McGowan, and Mick Stephenson, and a live Q+A with Dr Damien Easton.
Register now: https://my.demio.com/ref/ t5Oa0a7fKJxz4d81
Dr Damien Easton – Director of Strategy and Operations, Melbourne Brain Centre at the Royal Melbourne Hospital and CEO of the Australian Stroke Alliance Damien is the director of Strategy and Operations at the Melbourne Brain Centre Royal, Melbourne Hospital and interim CEO of the Australian Stroke Alliance. He led MRFF Frontier Stage 1 activities and Australia’s first mobile stroke unit (MSU). He leads the centre’s strategic and operational planning across more than 30 active projects involving national and international partnerships and close engagement with State and Federal health agencies.
Professor Geoffrey Donnan AO - professor of Neurology, The University of Melbourne and co-chair of the Australian Stroke Alliance Geoffrey is a professor of Neurology at The University of Melbourne and former Director of The Florey Institute of Neuroscience and Mental Health. His research interest is clinical stroke management. He was co-founder, with Professor Stephen Davis, of the Australian Stroke Trials Network. He is the cochair of the EXTEND group of trials, including the recently published EXTEND IA trial of thrombectomy in acute ischaemic stroke. He was Editor-in-Chief of the International Journal of Stroke and is Past President of the World Stroke Organization.
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Professor Stephen Davis AM – Director of the Melbourne Brain Centre at the Royal Melbourne Hospital, and co-chair of the Australian Stroke Alliance Stephen is a professor of Translational Neuroscience at the University of Melbourne, Director of the Melbourne Brain Centre at the Royal Melbourne Hospital and a Past-President of the World Stroke Organization. He co-chairs the Melbourne Mobile Stroke Unit program. His research is focussed on acute therapy for both ischemic stroke and intracerebral haemorrhage, particularly the use of advanced imaging in selection of therapy. He is the co-lead of the Frontiers MRFF grant on Pre-Hospital Stroke Care.
Mick Stephenson – Executive Director Clinical Operations, Ambulance Victoria Mick is an intensive care paramedic (MICA) and the executive director of Clinical Operations at Ambulance Victoria. He has state-wide responsibility for all road and air ambulance services including adult retrieval and the Victorian Stroke Telemedicine service. Mick’s interests in stroke include the development of the Melbourne Mobile Stroke Unit and the state’s system for equitable endovascular clot retrieval.
Sharon McGowan – CEO, Stroke Foundation Sharon is the chief executive officer at the Stroke Foundation. Sharon has worked in Australia and the UK with a range of government statutory authorities and not-for-profit organisations focused on community engagement, culture transformation, and health promotion. She is a board member of the World Stroke Organization, Co-Chair of the WSO Stroke Support Organisation Committee, Co-Chair of the Australian Stroke Coalition, and Chair of the Australian Chronic Disease Prevention Alliance.
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Events First
Upcoming Webinars Join us for our next sessions
Infection Prevention and Control post Pandemic Tuesday 25th May 2021
Never has the importance of Infection Control been more prevalent than as we navigate the COVID-19 pandemic, and this Extended Webinar features three leading experts in the field of Infection Control. Peter Collignon an Infectious Diseases Physician and Clinical Microbiologist at ACT Pathology and Canberra Hospital, and will share his knowledge of infection control and the impact of the COVID-19 Pandemic. Edward Johnson is an accidental speech pathologist, anthropologist, and public health researcher and will present “change is the only constant: climate, population, and disease patterns in 2020 and beyond”. Finally, Mark Regger, an Occupational Hygienist and Senior Application Engineer, will discuss respirator fit testing is and its place within a respiratory protection program.
Mark Regger - Occupational Hygienist and Senior Application Engineer, 3M Australia (Personal Safety Division) Mark is an Occupational Hygienist (MAIOH) whose current Senior Application Engineer role at 3M Australia (Personal Safety Division) focuses on providing technical end user guidance and advice around the selection, use and maintenance of personal protective equipment. This is backed through his previous experience as a Occupational Hygiene/Property Risk Consultant, Masters in Science (Occupational Hygiene Practice), Cert IV in OHS, NSW Licensed Asbestos Assessor (LAA001242) and 18 years in the safety equipment and training industry. Mark also hosts the “Science of Safety Podcast”, which is available on all major podcast platforms. He chats with expert guests on a range of WHS topics to provide practical advice and guidance for all workplaces. He is the Chair of the Australian Institute of Occupational Hygienists (AIOH) respiratory fit testing training and accreditation program RESP-FIT.
Register now: https://my.demio.com/ref/ Ng3ZNMpe6uw1MuY5
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Edward Johnson - Co-Founder of Umbo and Adjunct Senior Lecturer, Faculty of Medicine and Health at the University of Sydney Mr Johnson is a health policy researcher. His PhD is focused on digital capacity-building in rural and remote communities, aims to develop sustainable, equitable, and person-centred service delivery models in the bush. He now consults on public health policy; is Co-Founder of Umbo (an online allied health service), and Adjunct Senior Lecturer at the Faculty of Medicine and Health at the University of Sydney. He is NonExecutive Director at SARRAH, and Councillor at the National Rural Health Alliance. Ed is interested in the environmental impact that infectious and noninfectious diseases have on communities and human neurodevelopment, particularly relevant in a context of climate shift, emerging infectious and non-infectious diseases, and global population movements.
Peter Collignon AM - Infectious Diseases Physician and Clinical Microbiologist at ACT Pathology and Canberra Hospital In June 2009, Peter Collignon he was made a Member of the Order of Australia (AM) for services to Medicine in Infectious Diseases, Microbiology and Infection Control. In addition to his role at ACT Pathology and Canberra Hospital, he is also a Professor in the Medical School of the Australian National University. He is active in many public health advocacy issues, in particular antibiotic resistance, infection control and hospital acquired infections. He is member of many national and international committees, including as an expert to the World Health Organization (WHO) on the issue of antibiotic resistance and the use of antibiotics in food animals since 2000. He is also the inaugural and current patron of the Australian College for Infection Prevention and Control.
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CAA2021 Virtual Expo
22-24 June 2021, Access 24/7
Bringing the ambulance sector together CAA’s new Virtual Expo brings together members of the ambulance sector with innovative networking opportunities, sharing sector developments and groundbreaking technologies.
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Exhibition Halls Interactive Stands Demonstrations Mini-Masterclasses University Alley 1 on 1 Networking Sessions
Follow CAA social media channels for Virtual Expo updates
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ADVERTORIAL
Babcock reaches 20,000 hour milestone with Ambulance Victoria Babcock Australasia has achieved a significant in-service milestone with Ambulance Victoria, with its AW139 helicopter fleet exceeding 20,000 flying hours at the five year anniversary of entering service. Since January 2016, Babcock has supplied five AW139s, plus a service assurance aircraft, to support Ambulance Victoria’s Helicopter Emergency Medical Services (HEMS) operations. Babcock Australasia’s Chief Pilot and Head of Flying Operations (Onshore), Captain Tom House, said the achievement is testament to the strong collaboration with Ambulance Victoria. “Working in partnership with the customer, Babcock’s Aviation & Critical services team has maintained operations since the start of the pandemic and remained committed to service delivery,” Captain House said. “Babcock delivers mission-critical emergency medical services (EMS) and search and rescue (SAR) operations 365-days-a-year within on-call rapid response times.
Operating from bases in Essendon, La Trobe Valley, Bendigo and Warrnambool, Babcock’s AW139 crews fly more than 2,700 EMS and SAR missions each year across Victoria and Bass Strait.
Captain House said Babcock provides Ambulance Victoria with turnkey helicopter support services to maintain and fly the fleet of specialised medical emergency configured AW139 delivers missionhelicopters.
Babcock critical emergency medical services (EMS) and search and rescue (SAR) operations 365-days-a-year within on-call rapid response times. Captain Tom House,
“This includes early adoption of new technologies, custom configuration of specialised on-board aeromedical equipment, as well as bespoke aircraft cabin designs and fitouts suitable for HEMS and SAR operations,” Captain House said.
“All AW139s are equipped with a rescue winch allowing MICA paramedics to be lowered into remote places to rescue patients, including bushland, boats and the ocean.
Chief Pilot and Head of Flying Operations (Onshore), Babcock Australasia
“We also provide qualification training to pilots, aircrew and engineers as well as specialist aeromedical training to Ambulance Victoria’s Mobile Intensive Care Ambulance (MICA) Flight Paramedics. “Babcock pilots and aircrew officers work in a closeknit team with MICA paramedics, which is critical when conducting operations at short notice at all hours of the day and night, often in challenging weather conditions and involving traumatic circumstances. “As a result, there is a high level of professional respect between the crew members and a close bond forged by shared experiences.”
“Babcock’s expertise, commitment, and focus on safe practices in the most challenging of circumstances has helped saved many lives and 2020 saw almost 2,000 patients transported by HEMS. “Our long-term partnership with Ambulance Victoria and experience with HEMS continues to deliver significant benefit to more than 5.8 million people living in rural, regional and metropolitan Victoria.”
Partners First
Pandemic Pushes UK’s Annual Ambulance Sector Conference Online
T
he global pandemic has forced many changes in the way that organisations operate and communicate with their key stakeholders.
This is why the UKbased Association of Ambulance Chief Executives (AACE) - the representative body for ambulance services across the United Kingdom - has opted to run its annual Ambulance Leadership Forum (ALF) conference online for the first time ever on 18 May 2021, 09.00 - 17.00 UK BST. This unique event will once again place the spotlight firmly on UK ambulance services as they fight to meet UK Government performance targets and continue to improve clinical
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outcomes against a backdrop of rising demand that shows no signs of slowing, a key issue compounded by the Covid-19 pandemic. Funding and workforce pressures – as well as the challenges being faced by other parts of the UK’s NHS urgent and emergency care system, which are exacerbating the ambulance service’s problems by contributing to unnecessary handover delays at local hospital departments – are the top priorities for discussion at this unique online event. Using some of the latest interactive online event software, the format will continue to contain a mix of live speaker sessions, live panel / debate, networking, knowledge sharing presentations from UK national ambulance director groups and access to a sponsor content and exhibition area.
International delegates and visitors Steve Irving, ALF Event Director at AACE, says: “We are really looking forward to the new format and are keen to welcome our international colleagues in the same way we do at our annual face-to-face conference, which has grown to become the key event in the UK ambulance calendar. “In reality it is often only at a highly-tailored event like ALF that we can find the time to pause with colleagues who are facing similar challenges – especially during this global pandemic - and reflect on what we are doing well, where we can improve and what we need to do to enable us to continue to deliver effective ambulance services consistently and in a sustainable way. In short, our aim is for ALF to stimulate debates and ideas at a time when they are needed most.”
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The agenda Themes and topics to be explored during the day include: •
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Health inequalities and Public Health strategies for ambulance services Reducing violence and aggression towards ambulance staff
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Leading cultural change to become ‘employers of choice’
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Integrated Care Systems – the regional / local fit for ambulance services
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Quality Improvement for Patient Safety
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Staff welfare – suicide reduction
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Volunteering – what next?
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Workforce Race Equality Scheme – are we improving?
The main stage sessions will be complemented by a separate ‘View on Demand Auditorium’.” Steve Irving,
ALF Event Director at AACE
Speakers and contributors include: • Sir Simon Stevens – Chief Executive of NHS England • Lord Victor Adebowale – Crossbench Life Peer and Chair of NHS Confederation • Professor Sir Michael Marmot - Professor of Epidemiology at University College London, Director of the UCL Institute of Health Equity, and Past President of the World Medical Association • Edward Argar MP – UK Government Minister of State for Health • Chris Hopson – Chief Executive of NHS Providers • Daren Mochrie QAM – Chief Executive, North West Ambulance Services and Chair of AACE • Martin Houghton - Brown - Chief Executive of St John Ambulance, Priory of England & the Islands of the Order of St John • Professor Anton Emanuel – senior clinical lead for the NHS’s workforce race equality standard (WRES) programme • Roger Davidson - Director, System Transformation, NHS England and NHS Improvement
Says Steve Irving: “The main stage sessions will be complemented by a separate ‘View on Demand Auditorium’. Here you can choose to view experts present on a broad variety of topics. Mostly comprising of short ten minute recordings, these are designed to provide interesting updates on what’s happening in the UK ambulance sector and further afield. We hope to provide content from around the UK and from colleagues overseas, so whether you are in Melbourne or Manchester, there will be items of interest for everyone.” AACE will also use the new online ALF format to highlight some exceptional individuals at conference by featuring the work of their AACE / ALF award winners. AACE could not produce ALF without the support of its sponsors and again looks forward to having a range of companies and organisations joining us and contributing to what will be an exceptional conference online on May 18, 2021, so save the date. To register your interest in this event please visit https://aace.org. uk/alf More details from Steve Irving, ALF Event Director, Association of Ambulance Chief Executives, via steve.irving@aace.org.uk
....and many more
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Partners First
Australasian College of Paramedicine
T
he Australasian College of Paramedicine is the peak professional organisation supporting and representing over 10,000 paramedics and student paramedics from across Australia and New Zealand.
Our members include paramedics at all clinical levels across health, community, industrial, military and hospital settings, paramedicine academics and researchers, student paramedics, doctors and nurses working in the emergency medicine field, non-paramedic qualified staff working in paramedicine, retrievalists, first responders and volunteers.
What we do The College is focused on providing high quality services to our members and leadership for the paramedic profession. The College delivers conferences, professional development workshops, online learning, research events and opportunities, quarterly magazine, peer-reviewed journal and member grants for education and research activities.
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We support our members through assistance with meeting the Australian Health Practitioner Regulation Agency registration standards and the provision of other career and wellbeing services. We provide a respected voice in determining how changes in health service provision, legislation and clinical practice are shaped and implemented to enhance the quality of patient care. With a new strategic plan soon to be announced following consultation with members, the College is focused on increasing our member service offering through continuing professional development, education opportunities and member benefits; leading the profession to deliver excellence in patient-centred care; and advancing the development of evidenceinformed paramedicine research.
The College welcomes new members at all stages of their careers. There are numerous opportunities to become involved in College activities, through our member representative committees, advisory committees, special interest groups, working groups, conference organising committees and local events. Find out more, including how to join the College, at www.paramedics.org or contact us via info@paramedics.org 1300 730 450 (AU) 0800 730 450 (NZ)
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Learn, connect and grow with the latest in paramedic education. Over 400 online courses
Leading the profession for paramedics
Professional development and research opportunities
FREE CPD Tracker Build your network and career Join the College. Call us today to discuss membership options.
1300 730 450
www.paramedics.org @ACParamedicine
Supporting paramedics throughout their careers
Research First
Bringing the Hospital to the Patient: Aboard Australia’s first Stroke Treatment Ambulance By Dr Henry Zhao
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T
he patient had just vomited in the back cabin. She was previously well but an hour earlier had developed sudden onset headache and right hemiplegia. Pre-hospital mobile CT had diagnosed a large left intracerebral haemorrhage. Her blood pressure was stubbornly high despite escalating doses of intravenous nicardipine. The mobile stroke unit was en route to the nearest neurosurgical centre where the surgical team had been pre-notified. The hospital was still 4km away but her conscious state was progressively dropping. The neurologist and paramedic urgently discussed whether to continue driving or call a MICA unit for intubation. The decision was made to continue to the hospital.
A summary of the full article published in AHA/ASA Journals Vol. 51, No. 3 with Dr Henry Zhao, A/Prof Michael Stephenson, Dr Damien Easton, Ms Skye Coote, Ms Francesca Langenberg, Prof Geoffrey Donnan (co-chair of Australian Stroke Alliance) and Prof Stephen Davis (co-chair Australian Stroke Alliance) https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.027843
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Research First
Stroke treatment has come a long way. Despite being the second-highest cause of mortality worldwide, the condition was once managed on “hemiplegia wards” where patients received little more than comfort care. The era of highly effective reperfusion therapies for ischaemic stroke started with the first unequivocally positive trial of intravenous thrombolysis in 1995. Since then, further trials have confirmed the effectiveness
of thrombolysis in longer time windows (although less effective when given later). A second big milestone arrived in 2015 with the publication of five strongly positive trials for endovascular thrombectomy in large vessel occlusion. Through a minimally invasive procedure, fast and reliable mechanical vessel re-opening could be achieved and spare patients from the most severe forms of stroke. Therefore, modern stroke medicine has powerful tools in the armamentarium, but has one big limitation: TIME. Delays in treatment ultimately render reperfusion therapies futile as the at-risk tissue develops irreversible damage.
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In fact, reperfusion therapies may be dangerous if given too late due to the risk of haemorrhagic transformation. In current systems of care, delays are inevitable as there are many steps from emergency services activation, paramedic attendance, transportation to hospital, medical assessment, imaging and finally commencement of treatment. Despite enormous efforts to streamline inhospital processes, time to treatment has plateaued across Australia for many years and have gone backwards during the COVID-19 pandemic. Our work in Victoria shows that the average metropolitan stroke patient receiving thrombolysis spends just as much time in the pre-hospital phase (56 mins) than in the hospital phase (52 mins). Therefore, depending solely on trying to improve in-hospital workflows is destined to fail as a long-term solution to providing timely therapy to eligible stroke patients. The concept of a Mobile Stroke Unit is simple: a purpose-built ambulance that houses a mobile CT scanner and carries specialised staff and all necessary acute stroke drugs. This allows rapid pre-hospital diagnosis, imaging and treatment to occur at the scene of attendance. The first Mobile Stroke Unit was deployed in 2007 in southern Germany, with over 30 cities across the world subsequently hosting such units.
The Melbourne Mobile Stroke Unit commenced operation in 2017 as the first in Australia and the Oceania region. The local service was built with a Mercedes Sprinter™ series chassis with a long wheelbase and a custom box body to house the Neurologica CereTom™ CT scanner capable of standard CT-brain and intracranial CT-angiogram. In the initial phase, the Mobile Stroke Unit is staffed with a stroke neurologist or senior stroke fellow, stroke nurse, CT radiographer and two paramedics (of which one may be MICA). In Melbourne, the Mobile Stroke Unit primarily services the central metropolitan within a 20-kilometre radius of The Royal Melbourne Hospital home base. Ambulance Victoria provide central co-dispatch of the service with a local generalpurpose ambulance to all AMPDS suspected stroke cases. Alternatively, the Mobile Stroke Unit can be requested by an initial paramedic crew if the initial dispatch did not suspect stroke (this can also be outside the 20-kilometre radius). On average, the Mobile Stroke Unit is dispatched 6-7 times per day (8AM6PM) with around 60% of cases cancelled en route due to resolving or absence of stroke symptoms (compared to around 40% of stroke cases brought to hospital without the Mobile Stroke Unit). In the first 365 days of operation, the Mobile Stroke Unit provided pre-hospital thrombolysis to 100 patients (equivalent to a very busy acute stroke centre), delivered to 8 metropolitan hospitals. We compared the speed of treatment compared to stroke patients receiving in-hospital thrombolysis in metropolitan Melbourne immediately prior to commencement of the Mobile Stroke Unit.
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We discovered a very significant reduction of 42.5 mins in time from first ambulance dispatch to commencement of thrombolysis.[1] In addition, the rates of thrombolysis within the first “golden hour” from the start of stroke symptoms was increased 10-fold from 1.5% to 15%, whereas thrombolysis within the first 90 minutes was increased 4-fold from 12% to 48%. Much of this time saving was from avoidance of transport to hospital, but once on scene, the Mobile Stroke Unit was still significantly faster than if patients had been brought to the hospital. This speaks to the unavoidable delays experienced in-hospital which are not an issue for the Mobile Stroke Unit, such as triage processes, unavailability of the CT scanner (with another more urgent case) and junior staff needing more time to make decisions. Outside of thrombolysis, the Mobile Stroke Unit plays an equally important role in pre-hospital triage for advanced stroke treatments. Across Australia, comprehensive stroke centres with endovascular thrombectomy and neurosurgical services are limited almost exclusively to inner suburban centres. In the first operational year, the Mobile Stroke Unit facilitated endovascular thrombectomy for 42 patients.
Although this intervention cannot be provided outside hospital, prehospital diagnosis allows the patient to be transported immediately toa comprehensive stroke centre, bypassing the local hospital if necessary. We calculated that the Mobile Stroke Unit saved 51 mins to the start of thrombectomy for these patients, rising to 71 mins if they needed bypass from the local hospital.[1] Similarly, early diagnosis on the Mobile Stroke Unit allows notification and bypass to a neurosurgical centre, where unstable patients have gone to theatre within 30 mins of hospital arrival. Overall, the pilot phase of the Melbourne Mobile Stroke Unit has been extremely successful. We estimate over one operational year (365 days) that early treatment is expected to save 45 years from premature death or disabled living, just for patients with ischaemic stroke.[1] Despite the initial setup and maintenance costs of the program, we have shown that the service is cost-effective, below the threshold for which medications are accepted onto the national Prescription Benefits Scheme.[2] The benefits of using a Mobile Stroke Unit have been further confirmed by two recent strongly positive clinical trials in Germany and the USA where Mobile Stroke Units both increased thrombolysis rates and significantly improved post stroke outcomes.[3, 4]
In the next phase of the program (see Australian Stroke Alliance Page 20) we hope to expand Mobile Stroke Units across Australian capital cities (Sydney is already preparing for future rollout) while building a second-generation vehicle with new and improved mobile CT scanners. For those in rural, remote and Aboriginal communities we are building “Air Mobile Stroke Units” which will incorporate CT scanners in aircraft to deliver stroke care to those most in need of services. Finally, we are exploring strokecapable ambulances with telemedicine and portable CT scanning technologies such as “stroke helmets” to play a supportive role along with Mobile Stroke Units. The new era of pre-hospital stroke care is only just starting References 1. Zhao, H., et al., Melbourne Mobile Stroke Unit and Reperfusion Therapy: Greater Clinical Impact of Thrombectomy Than Thrombolysis. Stroke, 2020. 51(3): p. 922-930. 2. Kim, J., et al., Economic evaluation of the Melbourne Mobile Stroke Unit. Int J Stroke, 2020: p. 1747493020929944. 3. Ebinger, M., et al., Association Between Dispatch of Mobile Stroke Units and Functional Outcomes Among Patients With Acute Ischemic Stroke in Berlin. JAMA, 2021. 325(5): p. 454-466. 4. Grotta, J., J.M. Yamal, and S. Parker, Benefits of Stroke Treatment on a Mobile Stroke Unit Compared to Standard Management: BEST-MSU, in International Stroke Conference. 2021.
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W
e spoke with Dr Henry Zhao to further learn about the Mobile Stroke Unit, why it has been established in Australia and what we can expect for the future.
F. What prompted the establishment of the first Mobile Stroke Unit (MSU) in Australia? The biggest barrier to patients benefitting from highly effective stroke therapies is time delays. It has been estimated that for every 1 min delay in vessel reopening, around 2 million neurons are lost in a large stroke. This is partly due to poor community education in calling the ambulance early, but unfortunately, this is also the result of a myriad of pre-hospital and in-hospital workflow steps that need to be completed before treatment can commence. Around Australia, just 30% of patients eligible for thrombolysis receive this treatment within 60 minutes of arrival and this figure has plateaued for many years. Mobile Stroke Units have been operating around the world since 2007 with substantial improvements in treatment times. We, therefore, established the Melbourne Mobile Stroke Unit as the first of its kind in Australia to see whether we could achieve the same results in our own backyard. F. As a patient what am I likely to experience if I needed care by the MSU? The Mobile Stroke Unit model of care is unlike anything that the patient has experienced before. Patients experiencing a stroke are rapidly assessed in the house and then rushed to the Mobile Stroke Unit which is typically parked in their driveway. We then perform a few manoeuvres to raise the stretcher and shift the patient up the stretcher into a head cradle (to allow CT scanning). The mobile CT scanner moves over the patient’s head, unlike the typical in-hospital CT where the patient’s bed moves instead. After scanning, the neurologist can immediately see the images and order treatment to be started.
Our fastest scene arrival to thrombolysis commencement time is 16 mins. Even where the patient is ineligible for immediate treatment, the Mobile Stroke Unit team is able to explain the current situation to the patient and family and let the receiving hospital know of their arrival. F. What enhancements or improvements could we expect to see in version 2 of the MSU? The second-generation Mobile Stroke Unit is still in the planning stages but central to this will be an improved CT scanner that is faster, produces better image quality and has additional capabilities (such as CT-perfusion scans). Unsurprisingly, this will be a bigger and heavier scanner so the vehicle chassis will need to be different to accommodate this. We are also working on adding improved telemedicine technology with the hope that a single remote neurologist can potentially provide management to several Mobile Stroke Units at once. F. Has the COVID Pandemic impacted on the MSU service? The Melbourne Mobile Stroke Unit went out of service briefly when several of our staff members were unfortunately close contacts of a positive hospital nurse. Due to the difficulty in deep cleaning the CT scanner we also do not go to suspected COVID-19 positive patients. However, whilst treatment times have deteriorated significantly due to reorganisations to hospital emergency departments, the Mobile Strok Unit largely avoids these roadblocks and we have maintained the same optimised processes and times.
Dr Henry Zhao Consultant Neurologist Dr Henry Zhao is a consultant neurologist with appointments at The Royal Melbourne Hospital, Ambulance Victoria and The University of Melbourne. He is the medical coordinator and clinical lead for the Melbourne Mobile Stroke Unit and has completed a PhD in pre-hospital stroke care. Dr Henry Zhao on behalf of A/Prof Michael Stephenson, Dr Damien Easton, Ms Skye Coote, Ms Francesca Langenberg, Prof Geoffrey Donnan, Professor Stephen Davis and the Melbourne MSU collaboration.
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Professional development without leaving the lounge! Join our series of one hour webinars to fill the knowledge gap. Access an incredible line up of speakers, discussing thought provoking and stimulating topics that directly affect Paramedicine of today and tomorrow.
Judith Barker CEO, St John Ambulance Australia (NT) Inc.
Tuesday, 23 March 2020 Women in Leadership Panel 11.30 AEST
Georgeina Whelan Commissioner, ACT Emergency Services Agency Tracy Linford Deputy Commissioner (Crime, Counter-Terrorism and Specialist Operations), Queensland Police Service
Dr Damien Easton Melbourne Brain Centre and Australian Stroke Alliance
Thursday, 29 April 2021
The Future of Stroke in Pre-Hospital Care | 11.30 AEST
Sharon McGowan Stroke Foundation Mick Stephenson Ambulance Vic Professor Geoffrey Donnan AO The University of Melbourne and Australian Stroke Alliance
Mark Regger Occupational Hygienist and Senior Application Engineer, 3M Australia (Personal Safety Division)
Tuesday, 25 May 2021
Infection Prevention and Control post Pandemic | 11.00 AEST
Edward Johnson Co-Founder of Umbo and Adjunct Senior Lecturer, Faculty of Medicine and Health at the University of Sydney Peter Collignon AM Infections Diseases Physician and Clinical Microbiologist, ACT Pathology & Canberra Hospital
Tuesday, 22 June 2021
Securing a Sustainable Future | 11.30 AEST Alexis Percival Environmental & Sustainability Manager, Yorkshire Ambulance Service NHS Trust
For more information go to www.caa.net.au/webinars
Research First
The transition from clinician to manager: the paramedic experience By Karen Stewart IHCD, BSc, MHCM
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P
romotion from paramedic to manager is common in ambulance services across the world, yet there has, to date, been limited research on this topic related to the paramedics’ experience of this role transition. The purpose of this qualitative study was to explore the experiences of paramedics who had transitioned from clinician to manager and to capture these feelings and experiences in a research project. The limited available research suggests that in many professions and organisations, effective frontline staff, or clinicians, may be progressed and promoted to managerial roles with little support or training when there are clear differences in the role and responsibilities, and the researcher wanted to explore the anecdotal information that paramedics may be promoted to managerial positions because they are good clinicians and employees, not because they have leadership and management qualifications. Insufficient research could be found to identify if appropriate support and training was provided to paramedics before taking on a management role. In the clinical role of a paramedic, training provided is very process and policy-driven, and the softer people skills which could compliment good management are often gained through time and experience. Therefore, without appropriate training for paramedics, this could impede their efficiency as a manager.
Do people view you differently and does working within management affect the way other paramedics relate to their former peer? The study and research focused on the managers from an ambulance service that provides the ‘000’ emergency response service in Western Australia, and at the time of the research period had 1578 paid staff and 9005 volunteers covering the largest landmass in the world by a single ambulance service. There were 163 managers across various departments within the organisation (including operational and non-operational roles), with varying spans of influence. Many of these managers were promoted directly from paramedics into these management roles.
A qualitative approach was used for this study. Through purposive sampling, the researcher conducted semistructured interviews with paramedics who had made the transition to manager. The participants were from various backgrounds and services, and also had From a personal perspective, the researcher is a varying lengths of service in both their original role as registered paramedic in both Australia and the United a paramedic and as manager. During the interviews, the Kingdom, with a background of joining the Scottish participants were asked to describe how they felt and Ambulance Service in 1993. The approach to paramedic what their experiences were concerning this transition training and management styles in Scotland in 1997 from paramedic to manager. The researcher then were very militaristic. There was little performed a thematic analysis, and regard for nurturing and supportive Participants described during this analysis, she identified management approaches, rather it very feelings of isolation themes within all of the participant much focused on a managerial approach responses. on moving from the of “do as I say and don’t question decisions”. After working 20 years “on frontline, a lack of feeling Six key themes emerged during the the road” in various frontline roles, a part of the team ‘in green’ data analysis: ‘in at the deep end’, promotion to management was attained ‘lost your identity’, ‘sold your soul’, by the researcher with no official ‘desirable rather than essential’, training or prerequisite for any formal ‘street cred’, and ‘stand back and qualifications. Therefore, the researcher’s interest was take a breath’. Participants described feelings of isolation piqued when reflecting from being “on the road” with on moving from the frontline, a lack of feeling part of friends and colleagues, to then being in a managerial the team ‘in green’; however, they also reported that position. It posed the questions, and she contemplated, previously being a paramedic in some instances gave what happens to those collegial friendships and credibility in their new manager roles. Challenges relationships once a paramedic is promoted to a reported concerned no formal training before management position? transitioning into the role, and the lack of essential managerial experience. A summary of the full article published in the Australasian Journal of Paramedicine Vol. 18 (2021) with Associate Professor Vicki Cope & Dr Melanie Murray https://ajp.paramedics.org/index.php/ajp/article/view/861
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Research First
Within the research paper there are verbatim quotes from the participants which captured their true thoughts and feelings on the subject and each of the themes which emerged during the interviews. In at the deep end:
Street cred:
“There hasn’t really been any training prior to stepping back from the paramedic side of things.”
“Having the clinical knowledge just adds to I guess your street credibility.”
“So, my transition was a little bit in the deep end. The transition to the actual job was difficult.”
“I’ve had a lot of positivity in that they feel they’ve got a manager that they can approach.”
Lost your identity:
Stand back and take a breath:
“Especially in the beginning, you’ve lost your identity.’’ “There’s a green family out there but I don’t feel as connected as I used to everybody.”
“Time management is a real challenge. I think for paramedics, I think we’ve become very good at doing one thing at a time and we get very task focussed, which is a necessity in the role that we do.”
“Challenging at times. I think the first thing you notice is, you figure out who your friends were and who were the people that were just being friendly to you.”
“Don’t think you have to make a decision on the spot. Actually stand back, take a breath, take all the evidence in and do it that way.”
Sold your soul: “They felt that you had sold your soul or that you were no longer part of the team.” “The transition. Well, put it this way. On the Friday I would be out with the paramedics that I had known for years in the pub having a beer. This is just generalising here. On the Monday I would start my new role. The following Friday I would be absent from that because I wasn’t invited.” “Certainly one may be of almost a distrust or something along those lines where it kind of feels like they don’t see you as one of them anymore.” Desirable rather than essential: “That I didn’t have that depth of management experience.” “Desirable rather than essential.” “So, they were definitely ‘not required’.”
To conclude this article before reading the full publication, the information gained in this study would suggest that paramedics who transition to a manager role receive little to no prior training in management or leadership before taking on their new roles. Often any training which does occur is offered retrospectively and frequently takes place once an issue is identified and can be sometime after the role has commenced. In other healthcare professions this would appear to be also true, although there was limited available literature to reference. The researcher hopes that her results will add to the contemporary literature related to this topic and it is anticipated the information and knowledge obtained within this study may be beneficial to senior managers in developing recruitment programs and courses to provide to frontline paramedics. Further, this information may support paramedics in their transition from clinician to manager by providing them with advice concerning the importance of leadership and management education that is required to successfully transition to a management role.
Karen Stewart IHCD, BSc, MHCM
Senior Operations Manager - Country Operations Karen Stewart was the youngest female paramedic in Scotland in 1997 to graduate with a Graduate IHCD in Paramedicine and completed 20 years in the Scottish Ambulance Service in various clinical roles. In 2010 Karen undertook a Bachelor of Science which she was awarded by distance in 2012 as she emigrated to Australia. In that same year, Karen joined St John WA initially as a paramedic and soon became Clinical Governance Operations manager. Since then, Karen has held senior positions including Acting Head of Clinical Services, Country Operations, and her current substantive role of Senior Operations Manager - Country Operations. In January 2021 Karen completed a Masters in Healthcare Management through Murdoch University, and undertook a research project which focused on the transition from clinical to manager from a paramedics experience. This research was accepted for publication in the Australasian Journal of Paramedicine in January 2021.
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National Mental Health and Wellbeing Study of Police and Emergency Services A review by Patrice O’Brien Chief Community Officer, Beyond Blue
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A
s Beyond Blue completes the third and final phase of its National Mental Health and Wellbeing Study of Police and Emergency Services, the mental health organisation’s Chief Community Officer, Patrice O’Brien reflects on the lessons learned and some considerations about the way forward for the sector. Beyond Blue established the Police and Emergency Services Program in 2014 because of concern for the mental health and suicide risk of current and former police and emergency service workers, volunteers, and their families. Over the past seven years we’ve learned a lot, working collaboratively with agencies, peak bodies in the sector and government. It’s heartening to see the progress that’s been made collectively.
Police and Emergency Services Program Beyond Blue’s Police and Emergency Services Program commenced in 2014. A key element of the program, the National Mental Health and Wellbeing Study of Police and Emergency Services, began in 2016 and comprised three phases: • Phase 1: a qualitative narrative project (2016) that gathered the personal mental health experiences of current and former police and emergency services workers, as well as partners and family members. • Phase 2: a national baseline survey (2017-2018). The world’s most comprehensive national survey to date of police and emergency services mental health, Answering the call, provided baseline data of the mental health and wellbeing of more than 21,000 police and emergency services workers and volunteers. • Phase 3: a collaborative knowledge-to-action project (2019-2020) where police and emergency services agencies were supported to translate the evidence identified by Phases 1 and 2 of the research to promote wellbeing and mental health, support those affected by poor mental health and prevent suicide within their agencies.
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The National Mental Health and Wellbeing Study of Police and Emergency Services The Study highlighted three areas critical for promoting positive mental health in the sector: 1. It is essential to create mentally healthy workplaces to support police and emergency services employees and volunteers. Beyond Blue Chair, The Hon Julia Gillard AC, likened a supportive work culture to “giving everyone in the organisation a mental health inoculation”. 2. Police and emergency services personnel are more likely to experience high levels of distress but may not recognise the signs and symptoms. Improving mental health literacy and understanding how to protect one’s own mental health is crucial. 3. Individuals have a positive regard for, and are supportive of, colleagues experiencing mental health conditions. However, individuals still grapple with self-stigma which prevents them speaking openly about their own experiences and seeking support.
Answering the call Answering the call identified common challenges across all state, territory, and national jurisdictions and also across the sub-sectors (Ambulance, Fire and Rescue, Police, State Emergency Services) and provided insights into how the sector might move forward.
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Translating knowledge into action Following Answering the call, Beyond Blue moved to a collaborative knowledge-to-action project (2019-2020) with individual agencies. Based on the learnings from engaging with agencies, the following practical actions surfaced as ways to further progress towards leading practice.
Co-operation and collaboration •
•
Establish forums or working parties with broad organisational representation to respond to complex challenges, such as stigma and bullying, from multiple angles.
•
Promote collaboration not only within agencies but also across agencies to leverage lessons learned and to avoid duplication of effort across agencies who already experience resourcing shortages.
Mental health and wellbeing strategy design and implementation •
•
•
•
•
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Develop or update a formal, Executive-endorsed mental health and wellbeing strategy (and associated action plan) that broadly follows a ProtectPromote-Support framework and involves a broad range of stakeholders in the design process. Beyond Blue’s Good practice framework for mental health and wellbeing in police and emergency services organisations (2020), incorporates insights from the seven-year program and is a useful resource to assist with this strategic development. Use evidence informed actions wherever possible in preference to solutions that may be popular or fashionable but are not supported by research or identified as leading practice. Utilise a psychosocial risk assessment approach to further inform development and prioritisation of actions in the strategy. Develop a mental health and wellbeing champion network charged with broadening buyin to the strategy. Consider measuring strategy performance against a variety of benchmarks which could incorporate: the baseline established by Answering the call; annual wellbeing surveys; or potentially partnering with other agencies to benchmark at a sector level.
Promote a philosophy of shared or mutual responsibility for promoting and supporting mental health and wellbeing.
Welcome developments in recent years As a result of the findings of Answering the call, Beyond Blue made several recommendations for agencies and governments to continue to improve the mental health and wellbeing of police and emergency services personnel. In particular, Beyond Blue recommended that, under the leadership of the Australian Government, all governments should work together to address the findings, focusing on four key components: •
Government funding to ensure the ongoing delivery of agency programs
•
Best-practice interventions and programs (ideally, delivered by a national centre of excellence)
•
Workers’ compensation reform, and
•
Support for former employees.
Since the sector embarked on their path for change, the following welcome developments have unfolded: •
In response to the Senate inquiry into First Responders, The people behind 000: mental health of our first responders, the Australian Government has committed $4.5 million to the Department of Home Affairs to develop a national action plan for first responder mental health, as well as in principle support for workers’ compensation reform. It is hoped that the national action plan will lead to nationally coordinated actions, incorporating some of the other initiatives outlined below.
•
Several State and Territory governments have demonstrated a commitment to leading practice interventions and programs including an Australian Government commitment to fund a national centre of excellence for police and emergency services mental health. The Blue Hub model is being piloted in Victoria in a collaboration between The Police Association Victoria and Phoenix Australia.
•
The Australian Government committed $76 million for dedicated resources towards mental health supports in response to the ‘Black Summer’ 2019-20 bushfires across a range of initiatives.
•
$11.5 million in funding to the Black Dog Institute and Fortem Australia Limited recognises the importance of involving families and the broader community in supporting the mental health of police and emergency services personnel. It will provide mental health support directly to emergency services personnel and their families.
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A sector-led approach to the future With the close of the final phase of the Police and Emergency Services Study, and after many years of research, advocacy and driving change in the sector, Beyond Blue will shift our focus from a dedicated Police and Emergency Service program to supporting sustainable, national or sector-led approaches. Beyond Blue is committed to continuing to influence positive changes across all workplaces, including in the police and emergency services sector.
Beyond Blue recognises and commends the evidence-based initiatives and policy changes that are emerging or underway to improve police and emergency services personnel mental health. Beyond Blue will continue to advocate for governments, agencies, unions, peak bodies and other key stakeholders to collaborate and work together, which will ultimately lead to better outcomes for our police and emergency services personnel more quickly, and with less duplication.
Beyond Blue applauds the CAA’s commitment to playing a leadership and coordination role in bringing ambulance agencies together to address mental health challenges and to share agency learnings and resources. By working together, the ambulance sector will create greater positive change and impact for its staff and volunteers, and that is the outcome we are all aspiring to!
Police and Emergency Services Program publications National Mental Health and Wellbeing Study of Police and Emergency Services publications: •
Answering the call national survey reports:
- Executive Summary - Final report - Detailed report
•
National Mental Health and Wellbeing Study of Police and Emergency Services (2016-2020) - a summary of the three phases of Beyond Blue’s research examining mental health and wellbeing in Australia’s police and emergency services sector.
•
Good practice framework for mental health and wellbeing in police and emergency services organisations (2020) - a Good practice framework for mental health and wellbeing in police and emergency services organisations’ incorporating insights and learnings from the seven-year program.
If this article brings up any issues for you and you need to speak to someone please seek help. 24-hour support is available in Australia through Lifeline 24/7 Crisis Support on 13 11 14 or in New Zealand through Lifeline 24/7 Helpline on 0800 543 354.
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Ambulance Victoria’s
Recycling
Uniform program Most of us can relate to the ‘no man’s land’ section of our wardrobe, our personal hidden museums for all the clothes we no longer wear. It’s no different for paramedics, who have a raft of uniform options based on work, weather, or special event. There are cargo pants, a blue shirt, vest or jacket, safety wear, coveralls, and footwear for general work. If it rains, there’s wet weather clothing. If you’re part of a flight or bicycle crew, there’s a different uniform and there’s a dress uniform to be worn on more formal occasions. So, what happens to these items of clothing when you’re done with them? With over 6,000 paramedics and first responders, plus on average 300 new recruits annually, you can imagine how many articles of uniform clothing Ambulance Victoria issues each year. It’s a question Advanced Life Support (ALS) Paramedic and Team Manager Jo Algie asked herself 18 months ago when she noticed just how many old uniforms were lying around. She found almost new boots collecting dust on a shelf at a branch and thought that they would be much better off with a kid who didn’t have school shoes. That’s when Jo and her colleague Georgie Tyers (Senior Reserve Paramedic) decided to be the change they wanted to see and started a uniform recycling program with Ambulance Victoria.
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First, they established a group on Workplace by Facebook and put the call out for people to get involved and donate any un-needed uniforms that could be reused or recycled across a series of drop-off points and storerooms. Jo and Georgie were overwhelmed with the response and outgrew a branch storeroom in a matter of weeks. So far, they have reused or donated an astounding 5,300 cargo pants, 2,130 dress pants, 1,450 overalls, 5,350 shirts, 950 jumpers, 190 vests and reflective vests, 50 pairs of work boots, and 70 pairs of dress shoes. Nothing is wasted with old, torn, or even pieces of, uniforms repurposed – even shirts with missing buttons make the pile. Even with those numbers, there’s still another 12 tonnes of uniform awaiting processing and more clothing keeps coming. The act of recycling or repurposing so many uniform items not only helps paramedics reduce their carbon footprint, but it also becomes a larger community enterprise as the group has now developed networks to handle more than 15,000 pieces of clothing or shoes donated outside of Ambulance Victoria. Some Lions and Rotary groups have joined in the effort, holding working bees to help debadge (remove any branded patches) to make the uniforms appropriate for people outside of Ambulance Victoria. This has been done alongside a dedicated group of staff within AV’s Communication Centres in Burwood, lead by Duty Manager Shelley Olsen.
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There’s a growing list of people who have benefited from the donations: local primary kids growing into dress shoes, kitting out an entire indigenous school with shirts for students, cargo pants for apprentice tradies on low pay, people in emergency departments, emerging paramedic services overseas, and farmers in drought-affected areas. The program is not just about taking less from the planet but sharing more with the people who inhabit it. Ambulance Victoria’s ambition is to be a leading sustainable Australian ambulance and health service. This means sustainability will be part of what they do every day, now and in the future for AV, our people, patients, and the community. Ambulance Victoria has developed a framework to cover both social and environmental responsibility as a holistic approach to being a responsible ambulance service, which is directly linked to its Patient Care commitment to ensure Best Care is provided to every patient, every time. If you’d like to know more about Ambulance Victoria’s uniform recycling program or anything related to Sustainability at AV, please contact sustainability@ambulance.vic.gov.au
This year Jo, along with her peer dog Lexi (pictured), was awarded an Ambulance Service Medal for her work supporting the Gippsland community following the 2020 bushfires, and of course, for her remarkable efforts leading AV’s uniform recycling efforts.
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C
AA has been instrumental in providing networking and partnering opportunities for many years. We provide an important link between the ambulance sector and businesses that provide goods and services for this industry.
The Directory by CAA was established as a way we can continue these important partnerships throughout the year, not just during our events and campaigns. At its core, The Directory by CAA is a network that brings together companies and service providers, offering chances to connect and learn about each other.
DIAMOND TIER
Our all-inclusive tier will give you advertising opportunities across all CAA platforms, including FIRST by CAA, newsletters, social media and website.
RUBY TIER
The Directory introduces a dedicated page on CAA’s website where all product companies will be featured. In addition to this, The Directory will provide wonderful advertising opportunities from full-page ads in FIRST, fortnightly newsletters and exposure on our extensive social media platforms.
This intermediate tier offers great value capturing a varied assortment of advertising opportunities across the majority of CAA platforms.
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The CAA entry level Directory tier covers all the basics.
Being a part of The Directory by CAA will provide impressive exposure across the Australasian ambulance sector as well as reaching our global partners in Europe, UK, USA, Canada and across Asia.
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Wellness First
r u o y s i h c u m w Ho ? h t r o w health Ever heard the mantra, health is wealth? It’s so true - without health, what would we have? We especially know this in our work environment. Health is what lets us get up each morning and do the things we need to do, it’s what lets us go out with our friends, it’s what lets us take a walk outside and enjoy nature.
Mitch Mullooly Health and Wellness Strategist Specialising in the wellbeing of first responders, Mitch is the Chair of the Australasian College of Paramedicine, Aotearoa New Zealand; Council member of Te Kaunihera Manapou, New Zealand Paramedic Council; Advisory Committee member for Te Kiwi Maia, The Courageous Kiwi; and proud CAA2020 Women in Ambulance honour recipient. Mitch is also a published author, speaker and feature columnist for several sector related magazines, blogs, webinars, and podcasts.
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It is what we do every day that impacts our health, not what we do occasionally.” www.caa.net.au
For many, we don’t really understand how important health is until we don’t have it. No one wants to be a pessimist and think about a life where they aren’t able to do the everyday things they love to do, however, it’s important to recognise that our health could be fleeting and that we have one body and one life to live. That is what brings me to one of the most important things you can do for your health.
SELF-LOVE There are many ways to love yourself but taking care of your body and mind is the highest form of self-respect. Let’s give our bodies and our minds the respect they deserve: ✓ Eating real food is self-love ✓ Reducing toxins is self-love ✓ Exercising is self-love ✓ Managing stress is self-love ✓ Improving sleep is self-love ✓ Spending time outside is self-love ✓ Being kind to ourselves is self-love Be kind to your body and be kind to you. Taking care of yourself is the epitome of SELF-LOVE. We have an ability to make positive changes towards our health; that means WE have at least some control of our destinies. Did you know that those positive changes can reduce your risk of disease and help you live a more optimal life? We are the CEOs of our health! With the right motivation and right attitude, we CAN take charge of our health. We can put the puzzle pieces together; we can connect the necessary dots. Of course, it is not always so simple. This health transformation stuff is hard! Which leads me to my next big takeaway:
PROGRESS NOT PERFECTION We’re all a work in progress. I am a health coach and I don’t always do the things I preach (yep… I’m human!). I struggle sometimes. I make mistakes. I don’t always make the right decisions, but I get right back up again. I keep on truckin’ and I make progress. Our choices day in and day out matter but they aren’t everything. One poor choice here or there is probably not going to make or break your health. It’s about making better choices overall and not burdening ourselves or feeling ashamed for the occasional mishaps. The judgement you pass on yourself is what typically leads you to go back to do it again, so it’s time to put a full stop at the end of your sentences, not a comma after which judgement is expressed. For example, let’s say you eat too many Tim Tam. See it as it is, not better than it is, not worse than it is, just as it is. If you say to yourself – ‘I ate too many Tim Tam, therefore I’m hopeless, pitiful and I clearly have zilch willpower’ - do you think that inspires you to want to make better food choices at your next meal? No, unfortunately, the opposite occurs, because you feel like you’ve ruined everything. You haven’t ruined anything; you simply ate too many Tim Tam.
Body Confidence (For Life!) Guide
Instead of adding the comma to that sentence, it is far more empowering if you simply say, ‘I ate too many Tim Tam.’ No judgement. You can follow that sentence up with a question that prompts insight such as ‘I wonder why I did that?’. In that way, you bring curiosity, rather than judgement to your behaviours and this allows insights to flow. Getting to the heart of why you chose the Tim Tam in the first place will not only stop the negative self-talk in the moment, but it helps you to make a different choice next time. When we love ourselves and give our bodies and our minds the respect they deserve we also forgive. We all have our own paces, and our own struggles, remember tomorrow is always a new day. I want you to really care about your health, as without it we have nothing. When you are well you have 1000 goals, yet when you are unwell you have only one. I want you to be passionate about how you take care of yourself. Think of how much care, kindness, compassion, time and attention you give to others, it is time to care just as much about your own health and happiness. Get fired up about taking even better care of you!
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REUSE CLOTHING AND LINENS Find new homes for clothing and linens, or use them for rags, patchwork and other projects.
GREEN WASTE Each year over half our household garbage is made up of food and garden waste! Ask your local council what can be placed in your ‘Green Waste’ bin.
GO (NEARLY) PAPERLESS While recycling is helpful, the biggest impact comes from using less paper in the first place.
GLASS CAN BE RECYCLED AN INFINITE NUMBER OF TIMES Try to choose products packaged in glass over plastic.
SAVE ENERGY BY RECYCLING Recycling 1 plastic bottle saves enough energy to power a computer for 25 minutes.
For more sustainability tips head to www.caa.net.au/sustainable-ambulance-subpage
www.caa.net.au