Academic literature on the topic 'Ambulance service Victoria'

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Journal articles on the topic "Ambulance service Victoria"

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Eastwood, Kathryn, Amee Morgans, Karen Smith, Angela Hodgkinson, Gareth Becker, and Johannes Stoelwinder. "A novel approach for managing the growing demand for ambulance services by low-acuity patients." Australian Health Review 40, no. 4 (2016): 378. http://dx.doi.org/10.1071/ah15134.

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Objective The aim of the present study was to describe the Ambulance Victoria (AV) secondary telephone triage service, called the Referral Service (RS), for low-priority patients calling triple zero. This service provides alternatives to ambulance dispatch, such as doctor or nurse home visits. Methods A descriptive epidemiological review of all the cases managed between 2009 and 2012 was conducted, using data from AV case records, the Victorian Admitted Episodes Dataset and the Australian Bureau of Statistics. Cases were reviewed for patient demographics, condition, final disposition and RS outcome. Results In all, 107148 cases were included in the study, accounting for 10.3% of the total calls for ambulance attendance. Median patient age was 54 years and 55% were female. Geographically based socioeconomic status was associated with the rate of calls to the RS (r = –0.72; 95% confidence interval CI –0.104, –0.049; P < 0.001). Abdominal pain and back symptoms were the most common patient problems. Although 68% of patients were referred to the emergency department, only 27.6% of the total cases were by emergency ambulance; the remainder were diverted to non-emergency ambulance or the patient’s own private transport. The remaining 32% of cases were referred to alternative service providers or given home care advice. Conclusions This paper describes the use of an ongoing secondary triage service, providing an effective strategy for managing emergency ambulance demand. What is known about the topic? Some calls to emergency services telephone numbers for ambulance assistance consist of cases deemed to be low-acuity that could potentially be better managed in the primary care setting. The demand on ambulance resources is increasing each year. Secondary telephone triage systems have been trialled in ambulance services in the US and UK with minimal success in terms of overall impact on ambulance resourcing. What does this paper add? This study describes a model of secondary telephone triage in the ambulance setting that has provided an effective way to divert patients to more suitable forms of health care to meet their needs. What are the implications for practitioners? The implications for practitioners are vast. Some of the issues that currently face paramedics include: fatigue because of high workloads; skills decay because of a lack of exposure to patients requiring intervention with skills the paramedics have, as well as a lack of time for paramedics to practice these skills during their downtime; and decreasing job satisfaction linked to both these factors. Implications for patients include quicker response times because more ambulances will be available to respond and increased patient safety because of decreased fatigue and higher skill levels in paramedics.
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Joyce, Catherine M., Jo Wainer, Frank Archer, Andrea Wyatt, and Leon Pitermann. "Trends in the paramedic workforce: a profession in transition." Australian Health Review 33, no. 4 (2009): 533. http://dx.doi.org/10.1071/ah090533.

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Ambulance services play a key role in the Australian health system, as the primary providers of pre-hospital clinical care, emergency care and specialised transport.1 Although at present there is a strong focus on broad health system reform, and health workforce reform specifically, little attention has been paid to the place of pre-hospital clinical care and the paramedic workforce that provides these services. Despite their significant role in the health system, there is no strategic national approach by government to the development of ambulance services or the paramedic workforce. In this paper, we review current and emerging trends impacting on the paramedic workforce. We examine changes in patterns of ambulance service provision and the nature of clinical work undertaken by paramedics, as well as developments in education, training and career pathways. We focus on the current situation in Victoria to illustrate and identify a number of important implications of current changes, for the profession, service and training providers, and policy makers.
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Eastwood, Kathryn, Dhanya Nambiar, Rosamond Dwyer, Judy A. Lowthian, Peter Cameron, and Karen Smith. "Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study." BMJ Open 10, no. 11 (November 2020): e042351. http://dx.doi.org/10.1136/bmjopen-2020-042351.

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BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.
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Smith, Erin C., Frederick M. Burkle, Paul F. Holman, Justin M. Dunlop, and Frank L. Archer. "Lessons from the Front Lines: The Prehospital Experience of the 2009 Novel H1N1 Outbreak in Victoria, Australia." Disaster Medicine and Public Health Preparedness 3, S2 (December 2009): S154—S159. http://dx.doi.org/10.1097/dmp.0b013e3181be8250.

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ABSTRACTThe H1N1 (swine influenza) 2009 outbreak in Victoria, Australia, provided a unique opportunity to review the prehospital response to a public health emergency. As part of Ambulance Victoria’s response to the outbreak, relevant emergency response plans and pandemic plans were instigated, focused efforts were aimed at encouraging the use of personal protective equipment (PPE), and additional questions were included in the call-taking script for telephone triage of emergency calls to identify potential cases of H1N1 from the point of call. As a result, paramedics were alerted to all potential cases of H1N1 influenza or any patient who met the current case definition before their arrival on the scene and were advised to use appropriate PPE. During the period of May 1 to July 2, Ambulance Victoria telephone triaged 1598 calls relating to H1N1 (1228 in metropolitan areas and 243 in rural areas) and managed 127 calls via a referral service that provides specific telephone triage for potential H1N1 influenza cases based on the national call-taking script. The referral service determines whether a patient requires an emergency ambulance or can be diverted to other resources such as flu clinics. Key lessons learned during the H1N1 outbreak include a focused need for continued education and communication regarding infection control and the appropriate use of PPE. Current guidelines regarding PPE use are adequate for use during an outbreak of infectious disease. Compliance with PPE needs to be addressed through the use of intra-agency communications and regular information updates early in the progress of the outbreak. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S154–S159)
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Xu, B. "Delivery of ambulance service by volunteers in Victoria, Australia: an ethical dilemma?" Journal of Medical Ethics 34, no. 10 (October 1, 2008): 704–5. http://dx.doi.org/10.1136/jme.2007.022376.

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Boyle, Malcolm J., M. ClinEpi, Erin C. Smith, and Frank L. Archer. "Trauma Incidents Attended by Emergency Medical Services in Victoria, Australia." Prehospital and Disaster Medicine 23, no. 1 (February 2008): 20–28. http://dx.doi.org/10.1017/s1049023x00005501.

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AbstractIntroduction:International literature describing the profile of trauma patients attended by a statewide emergency medical services (EMS) system is lacking. Most literature is limited to descriptions of trauma responses for a single emergency medical service, or to patients transported to a specific Level-1 trauma hospital. There is no Victorian or Australian literature describing the type of trauma patients transported by a state emergency medical service.Purpose:The purpose of this study was to define a profile of all trauma incidents attended by statewide EMS.Methods:A retrospective cohort study of all patient care records (PCR) for trauma responses attended by Victorian Ambulance Services for 2002 was conducted. Criteria for trauma categories were defined previously, and data were extracted from the PCRs and entered into a secure data repository for descriptive analysis to determine the trauma profile. Ethics committee approval was obtained.Results:There were 53,039 trauma incidents attended by emergency ambulances during the 12-month period. Of these, 1,566 patients were in physiological distress, 11,086 had a significant pattern of injury, and a further 8,931 had an identifiable mechanism of injury. The profile includes minor trauma (n = 9,342), standing falls (n = 20,511), no patient transported (n = 3,687), and deceased patients (n = 459).Conclusions:This is a unique analysis of prehospital trauma. It provides a baseline dataset that may be utilized in future studies of prehospital trauma care. Additionally, this dataset identifies a ten-fold difference in major trauma between the prehospital and the hospital assessments.
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Cantwell, Kate, Amee Morgans, Karen Smith, Michael Livingston, and Paul Dietze. "Improving the coding and classification of ambulance data through the application of International Classification of Disease 10th revision." Australian Health Review 38, no. 1 (2014): 70. http://dx.doi.org/10.1071/ah13163.

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Objectives This paper aims to examine whether an adaptation of the International Classification of Disease (ICD) coding system can be applied retrospectively to final paramedic assessment data in an ambulance dataset with a view to developing more fine-grained, clinically relevant case definitions than are available through point-of-call data. Methods Over 1.2 million case records were extracted from the Ambulance Victoria data warehouse. Data fields included dispatch code, cause (CN) and final primary assessment (FPA). Each FPA was converted to an ICD-10-AM code using word matching or best fit. ICD-10-AM codes were then converted into Major Diagnostic Categories (MDC). CN was aligned with the ICD-10-AM codes for external cause of morbidity and mortality. Results The most accurate results were obtained when ICD-10-AM codes were assigned using information from both FPA and CN. Comparison of cases coded as unconscious at point-of-call with the associated paramedic assessment highlighted the extra clinical detail obtained when paramedic assessment data are used. Conclusions Ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Coding of ambulance data using ICD-10-AM allows for comparison of not only ambulance service users but also with other population groups. What is known about the topic? There is no reliable and standard coding and categorising system for paramedic assessment data contained in ambulance service databases. What does this paper add? This study demonstrates that ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Representation of ambulance case types using ICD-10-AM-coded information obtained after paramedic assessment is more fine grained and clinically relevant than point-of-call data, which uses caller information before ambulance attendance. What are the implications for practitioners? This paper describes a model of coding using an internationally recognised standard coding and categorising system to support analysis of paramedic assessment. Ambulance data coded using ICD-10-AM allows for reliable reporting and comparison within the prehospital setting and across the healthcare industry.
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Zhao, Henry, Lauren Pesavento, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, et al. "009 The ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithmic pre-hospital triage tool for endovascular thrombectomy: ongoing paramedic validation." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 6 (May 24, 2018): A5.1—A5. http://dx.doi.org/10.1136/jnnp-2018-anzan.9.

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IntroductionThe ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithm is a severity based 3-step paramedic triage tool for pre-hospital recognition of large vessel occlusion (LVO), designed to improve specificity and paramedic assessment reliability compared to existing triage scales. ACT-FAST sequentially assesses 1. Unilateral arm fall to stretcher <10 s; 2a. Severe language disturbance (right arm weak), or 2b. Severe gaze deviation/hemi-neglect assessed by shoulder tap (left arm weak); 3. Clinical eligibility questions. We present the results of the ongoing Ambulance Victoria paramedic validation study.MethodsAmbulance Victoria paramedics assessed ACT-FAST in all suspected stroke patients pre-hospital in metropolitan Melbourne, Australia, and in the Royal Melbourne Hospital Emergency Department since July 2017. Algorithm results were validated against a comparator of ICA/M1 occlusion on CT-angiography with NIHSS ≥6 (Class 1 indications for endovascular thrombectomy).ResultsData were available from n=119 assessments (ED n=68, pre-hospital n=51). Patient diagnoses were LVO n=20 (15.6%), non-LVO infarcts n=45 (38.5%), ICH n=10 (8.3%) and no stroke on imaging n=44 (37.6%). ACT-FAST showed 85% sensitivity, 88.9% specificity, 60.7% (72% excluding ICH) positive predictive value and 96.7% negative predictive value for LVO. Of 10 false-positives, 4 received thrombectomy for non-Class 1 indications (basilar/M2 occlusions/cervical dissection), 3 were ICH, and 1 was tumour. Three false-negatives were LVO with milder syndromes.DiscussionThe ongoing ACT-FAST algorithm validation study shows high accuracy for clinical recognition of LVO. The streamlined algorithmic approach with just two examination items provides a more practical option for implementation in large emergency service networks. Accurate pre-hospital recognition of LVO will allow bypass to endovascular centres and early activation of neuro-intervention services to expedite endovascular thrombectomy.
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Mercier, Eric, Peter A. Cameron, Karen Smith, and Ben Beck. "Prehospital trauma death review in the State of Victoria, Australia: a study protocol." BMJ Open 8, no. 7 (July 2018): e022070. http://dx.doi.org/10.1136/bmjopen-2018-022070.

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IntroductionRegionalised trauma systems have been shown to improve outcomes for trauma patients. However, the evaluation of these trauma systems has been oriented towards in-hospital care. Therefore, the epidemiology and care delivered to the injured patients who died in the prehospital setting remain poorly studied. This study aims to provide an overview of a methodological approach to reviewing trauma deaths in order to assess the preventability, identify areas for improvements in the system of care provided to these patients and evaluate the potential for novel interventions to improve outcomes for seriously injured trauma patients.Methods and analysisThe planned study is a retrospective review of prehospital and early in-hospital (<24 hours) deaths following traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria between 2008 and 2014. Eligible patients will be identified from the Victorian Ambulance Cardiac Arrest Registry and linked with the National Coronial Information System. For patients who were transported to hospital, data will be linked the Victoria State Trauma Registry. The project will be undertaken in four phases: (1) survivability assessment; (2) preventability assessment; (3) identification of potential areas for improvement; and (4) identification of potentially useful novel technologies. Survivability assessment will be based on predetermined anatomical injuries considered unsurvivable. For patients with potentially survivable injuries, multidisciplinary expert panel reviews will be conducted to assess the preventability as well as the identification of potential areas for improvement and the utility of novel technologies.Ethics and disseminationThe present study was approved by the Victorian Department of Justice and Regulation HREC (CF/16/272) and the Monash University HREC (CF16/532 – 2016000259). Results of the study will be published in peer-reviewed journals and reports provided to Ambulance Victoria, the Victorian State Trauma Committee and the Victorian State Government Department of Health and Human Services.
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Eastwood, Kathryn, Stuart Howell, Ziad Nehme, Judith Finn, Karen Smith, Peter Cameron, Dion Stub, and Janet E. Bray. "Impact of a mass media campaign on presentations and ambulance use for acute coronary syndrome." Open Heart 8, no. 2 (October 2021): e001792. http://dx.doi.org/10.1136/openhrt-2021-001792.

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ObjectiveBetween 2009 and 2013, the National Heart Foundation of Australia ran mass media campaigns to improve Australian’s awareness of acute coronary syndrome (ACS) symptoms and the need to call emergency medical services (EMS). This study examined the impact of this campaign on emergency department (ED) presentations and EMS use in Victoria, Australia.MethodsThe Victorian Department of Health and Human Services provided data for adult Victorian patients presenting to public hospitals with an ED diagnosis of ACS or unspecified chest pain (U-CP). We modelled changes in the incidence of ED presentations, and the association between the campaign period and (1) EMS arrival and (2) referred to ED by a general practitioner (GP). Models were adjusted for increasing population size, ACS subtype and demographics.ResultsBetween 2003 and 2015, there were 124 632 eligible ED presentations with ACS and 536 148 with U-CP. In patients with ACS, the campaign period was associated with an increase in ED presentations (incidence rate ratio: 1.11; 95% CI 1.07 to 1.15), a decrease in presentations via a GP (adjusted OR (AOR): 0.77; 95% CI 0.70 to 0.86) and an increase in EMS use (AOR: 1.10; 95% CI 1.05 to 1.17). Similar, but smaller associations were seen in U-CP.ConclusionsThe Warning Signs Campaign was associated with improvements in treatment seeking in patients with ACS—including increased EMS use. The increase in ACS ED presentations corresponds with a decrease in out-of-hospital cardiac arrest over this time. Future education needs to focus on improving EMS use in ACS patient groups where use remains low.
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Dissertations / Theses on the topic "Ambulance service Victoria"

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O'Meara, Peter Francis Public Health &amp Community Medicine Faculty of Medicine UNSW. "Models of ambulance service delivery for rural Victoria." Awarded by:University of New South Wales. Public Health and Community Medicine, 2002. http://handle.unsw.edu.au/1959.4/18771.

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The primary aim of the research project was to develop conceptual models of rural ambulance service delivery based on different worldviews or philosophical positions, and then to compare and contrast these new and emerging models with existing organisational policy and practice. Four research aims were explored: community expectations of pre-hospital care, the existing organization of rural ambulance services, the measurement of ambulance service performance, and the comparative suitability of different pre-hospital models of service delivery. A unique feature was the use of soft systems methodology to develop the models of service delivery. It is one of the major non-traditional systems approaches to organisational research and lends itself to problem solving in the real world. The classic literature-hypothesis-experiment-results-conclusion model of research was not followed. Instead, policy and political analysis techniques were used as counter-points to the systems approach. The program of research employed a triangulation technique to adduce evidence from various sources in order to analyse ambulance services in rural Victoria. In particular, information from questionnaires, a focus group, interviews and performance data from the ambulance services themselves were used. These formed a rich dataset that provided new insight into rural ambulance services. Five service delivery models based on different worldviews were developed, each with its own characteristics, transformation processes and performance criteria. The models developed are titled: competitive; sufficing; community; expert; and practitioner. These conceptual models are presented as metaphors and in the form of holons and rich pictures, and then transformed into patient pathways for operational implementation. All five conceptual models meet the criteria for systemic desirability and were assessed for their political and cultural feasibility in a range of different rural communities. They provide a solid foundation for future discourse, debate and discussion about possible changes to the way pre-hospital services are delivered in rural Victoria.
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O'Meara, Peter Francis. "Models of ambulance service delivery for rural Victoria /." 2002. http://www.library.unsw.edu.au/~thesis/adt-NUN/public/adt-NUN20030401.152156/index.html.

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Porter, Sandra. "An exploration of the support needs of ambulance paramedics." Thesis, 2013. https://vuir.vu.edu.au/22296/.

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The work of ambulance paramedics is usually physically and emotionally draining and can place significant amounts of pressure on the emergency service worker. The work they do can impact their social life, their family and ultimately, their health. The primary aim of this research was to explore the psychological and social coping strategies of ambulance paramedics, in dealing with the day to day aspects of their work in the context of their long term health and well-being. A secondary aim was to examine the use of current peer support programs and other referral services used by paramedics. This study was a qualitative exploration of the experiences of ambulance paramedics through interviewing. Qualitative research has allowed the researcher to capture the stories of individuals, in their own words. This study included nine novice paramedics (first year) and 12 longer term employed (five plus years) paramedics within Rural Ambulance Victoria. Participants were also recruited to reflect the gender ratio in the paramedic workforce.
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Dawson, David. "Experiential and Organisational Factors Predicting the Mental Health of Emergency Paramedics: Beyond the Trauma." Thesis, 2021. https://vuir.vu.edu.au/42952/.

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This research aimed to investigate the prevalence and distribution of mental health conditions across the paramedic workforce, to compare levels with the general population and to assess the association of stressors with scores on measures of mental health. A survey was constructed to assess general psychological health, depression, anxiety, stress, suicidality, posttraumatic stress disorder, sleep health and the frequency and severity of stressor variables. Impact scores for stressor variables were generated by multiplying frequency and severity scores. Participant and workplace sociodemographic variables were measured. The survey was distributed within Ambulance Victoria in September 2010. Only data from 879 participants that transported emergency patients was analysed. The ANOVA procedure and chi-square tests were employed to compare means and prevalences of psychological health scores within the paramedic sample according to sociodemographic variables. Independent-sample t-tests and chi-square tests for independence were used to examine means and prevalence rates by comparing this paramedic sample with general population statistics and other paramedic populations. Logistic and multiple regression analyses were conducted to investigate associations between stressor impact scores and mental health conditions. Key findings were the higher levels of suicidal thinking and planning, PTSD, substandard sleep health and poor general psychological health compared to the general population. The level of PTSD was comparable to other paramedic populations while suicidality was higher: there were mixed findings on the other measures. Regression analyses found that stressors related to the organisation, the broader work context and shift work were significantly associated with measures of mental health while, with the exception of anxiety, emergency work was not. There were no meaningful differences in levels of mental health conditions within groups across the paramedic workforce except that PTSD caseness was higher outside the major cities and, higher levels of suicidality were reported in three ambulance service regions. The higher levels of suicidality in this paramedic sample is a new finding although further research is needed to determine its nature and sources. Many stressors associated with mental health are not emergency work related but are instead associated with the organization and aspects of the broader working environment, suggesting that some stressors may be amenable to being managed. The lack of meaningful differences within this paramedic sample indicates that targeting mental health interventions is not practical, and should instead be directed across the entire workforce.
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Godfredson, Jeffrey. "An International Comparison of Emergency Medical Services Delivery Systems: Which Produces The Optimum Outcome For The Patient?" Thesis, 2018. https://vuir.vu.edu.au/37851/.

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This thesis was written to address a problem with ambulance service delivery times in Victoria, Australia. For a number of years, ambulance response times have been increasing to unacceptable levels. As a result of the ever-increasing problem it was appropriate to see if the are other alternative solutions producing better results. There are a number of different service delivery models for Emergency Medical Services (EMS) around the world. The main two are the Anglo/American model (also known as scoop and run) and the Franco/German model (also known a stay and play). There are also two major delivery agencies; the British model of a separate third party public sector service as used in UK, Australia and New Zealand or the fire service model where the fire service is the main delivery agency such as most of Asia, Europe and North America. Which model provides the best outcome for the patient? Such research has not been done in the past. The research will also examine if the Metropolitan Fire brigade has capacity to undertake possible EMS roles. A number of case studies were undertaken and explored with key issues of response times, patient outcomes, skills and new technologies compared. The results, particularly of response time show that in Victoria the response time for fire EMS (8.3 minutes) to medical emergencies is similar to that provided by fire services delivering EMS in North America. The MFB in Victoria is providing the equivalent of first responder; the American and Canadian fire services are delivering Advanced Life Support (ALS). The response times for Basic Life Support (BLS) in Victoria provided by ambulance service are over twice as long (8.3 minutes for fire compared to 18.2 minutes for Victorian Ambulance at the 90%). The US and Canadian Fire Services provide EMS response time considerably lower than Ambulance Victoria, some as low as 7.43 minutes. UK Ambulance (on which the Victorian model is based) also provides response time considerably less than Ambulance Victoria. The issue of whether the fire service in Victoria has capacity to undertake further EMS delivery was explored and whilst it has the capacity it is doubtful it could be delivered in the current industrial environment with the union having the capability of vetoing managerial decisions. The research raised fundamental questions regarding the effective use of scarce public sector resources and agencies working across organisational boundaries in the interests of serving the public. Data analysis involved pattern matching, explanation building and time series analysis to identify trends and commonalities across the cases. A number of themes emerged including continued increases in call volumes, challenges meeting response times and the development of proactive programs to reduce the impact of these trends.
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Hartley, Peter Ross. "Paramedic practice and the cultural and religious needs of pre‐hospital patients in Victoria." Thesis, 2012. https://vuir.vu.edu.au/21301/.

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Religion and culture can impact profoundly on healthcare practices and health outcomes. The Australian community is rich and diverse in differing cultures and religions, and at times of medical emergency the paramedic increasingly will be required to respond to healthcare needs of this diverse community. This study is designed to investigate current paramedic practices as they relate to an awareness of the cultural and religious needs of community groups as a holistic approach. It also incorporates the voices of these community groups from their experiences with emergency paramedics during pre‐hospital health care for those living in Melbourne, Australia.
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Books on the topic "Ambulance service Victoria"

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Victoria. Office of the Auditor-General. Access to ambulance services. Melbourne, Vic: Victorian Government Printer, 2010.

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Lasry, Lex. Metropolitan Ambulance Service Royal Commission. Melbourne]: Government Printer for the State of Victoria, 2001.

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Victoria. Office of the Auditor-General. Test calls made to non-emergency ambulance telephone lines. Melbourne]: Victorian Auditor-General's Office, 2000.

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Lasry, Lex. Report of the Metropolitan Ambulance Service Royal Commission. Melbourne, Vic: Parliament of Victoria, 2001.

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Victoria. Office of the Auditor-General. Metropolitan Ambulance Service: Contractual and outsourcing practices. Melbourne: Govt. Printer, 1997.

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Victoria. Office of the Auditor-General. Metropolitan Ambulance Service: Fulfilling a vital community need. [Melbourne]: Victorian Government Printer, 1997.

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Victoria. Office of the Auditor-General. Victorian rural ambulance services: Fulfilling a vital community need. [Melbourne]: Victorian Government Printer, 1997.

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Auditor-General, Victoria Office of the. Management of unplanned leave in emergency services. Melbourne, Vic: Victorian Government Printer, 2013.

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Metropolitan Ambulance Service: Contractual and outsourcing practices. Victoria: Victorian Govt. Printer, 1997.

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Victoria. Metropolitan Ambulance Service: Fulfilling a vital community need (Special report / Auditor-General of Victoria). Victorian Government Printer, 1997.

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