St John boss in push to improve services

Peter Bradley. Photo / Doug Sherring

Access to patient survival data critical for lifting care, says chief.

Survival rates for cardiac arrest, strokes and trauma victims are among the medical records that the new St John boss wants hospitals to provide in order to improve patient care.

Chief executive Peter Bradley is making a number of changes to the organisation in a bid to cope with ever increasing 111 calls and funding shortfalls of millions of dollars each year.

He told the Herald that a restructure of senior management positions was to ensure "accountability and transparency" in a drive for better performance and a strong focus on patients.

Currently, the only measure for St John is response times to emergency calls which have particularly deteriorated in urban areas, such as Auckland.

However, Mr Bradley wants access to medical records to measure the survival rates of patients taken to hospital by ambulance after they have suffered from cardiac arrest, strokes and trauma.

Similar data was collated by the Department of Health in Britain, where Mr Bradley was running the London Ambulance Service until late last year. The most recent statistics showed the London ambulances had a survival rate of 32 per cent for cardiac arrests, the best in the country and comparable with the best in the world.

Mr Bradley said all the changes in St John were planned to improve patient care but needed to be backed up with evidence.

"The public expects an ambulance to arrive in a timely fashion. That's the most important thing and there's no getting away from that.

"On top of that, we have to have some patient outcome measures. Things like cardiac arrest survival, which, for me, is the absolute golden standard for every ambulance service across the world to be able to measure.

"We currently aren't able to do that. That's going to change."

Mr Bradley has been speaking with District Health Boards, the Ministry of Health and ACC about the proposal to access the medical data. He hoped to be able to adopt the survival rate comparison used in Britain in the next six to nine months.

The data would then be reported publicly, he said. "I bring a really strong patient focus to St John and I'm really committed to that."

The new performance measures will also help the charitable organisation negotiate with the Government agencies for increased revenue, or perhaps a different funding model.

Already, ambulances are no longer sent to minor 111 calls as part of sweeping changes to help stem a $15 million-a-year loss.

Instead, the callers are given advice over the phone, redirected to a GP or other health carer, or a St John officer will be sent in a car.

The changes are to help cope with the steadily increasing number of elderly people with chronic illnesses, leading to an annual 4.5 per cent increase in demand.

Mr Bradley has admitted the single-crewed car model had experienced "teething problems" and need to run alongside - instead of - ambulances on the road.

He said Auckland definitely needed more ambulances, which cost around $1 million yearly to run.

But by re-directing patients away from hospital to relieve pressure on the groaning health system, St John is missing out on revenue. "We get funded by ACC for transporting patients to hospital who have been injured. If we look to find alternatives for patients, if we don't take them to hospital, we don't get paid." Additional reporting Martin Johnston

Raising the benchmark

* The new St John boss wants hospitals to provide survival rates for cardiac arrest, strokes and trauma victims.

* He hopes to be able to adopt the survival rate comparison used in Britain in the next six to nine months.

* Currently, the only measure for St John is response times to emergency calls.