Today our members would have received an email from the Executive Director Ambulance Operations outlining plans to manage crews who do not clear from the hospital within 15 minutes of Transfer of Care (ToC). The email outlines how ‘To support job cycle times, the MM-SOC may call crews whilst they are at Emergency Departments to check in, assess ramping possibilities and support the Transfer of Care (TOC) process.’ And goes on to say ‘If crews are being delayed past the 15-minute TOC alert on CAD, the MM-SOC will check in with crews again to see what additional support they need to clear…[and]…if your Make Ready time is expected to take longer than 15 minutes to be operational post TOC (such as extended cleaning requirements etc), crews should speak with the MM-SOC to discuss their additional requirements and request a P8 card.’
Further, we have many emails and calls from members who have already begun to receive emails or who have had ‘meetings’ with Depot Area Managers to discuss turnaround time averages that exceed 15 minutes.
If only St John ‘performance managed’ their own failure to meet the 15 minute target for Priority 1 calls. As we move toward the opening of interstate borders on 5th February, and with community transmission of the COVID Omicron variant already occurring, our members do not need reminding that Infection Prevention and Control is a critical process in respect to ambulance cleaning and decontamination. Our members regularly treat and transport elderly and other immunocompromised patients who may be particularly vulnerable to a COVID infection, and therefore the proper cleaning processes of equipment and surfaces is essential to protecting our next patient.
The AEAWA do not believe it is possible to complete the essential ePCR documentation, restock and appropriately and safely CLEAN our vehicles and equipment within 15 minutes after any potentially infectious patient, never mind have an opportunity to use restroom facilities, or take refreshments especially after wearing full PPE. This latest move by St. John highlights the importance of our claim for paid breaks.
We will say it again, St John have had two years to prepare for community transmission, and it seems their plan all along has simply been ‘volunteers’ and ‘crack the whip harder’. We have suggested to St John that they have dedicated cleaners based at hospitals with spare vehicles ‘made ready’ to enable a SAFER fast turn-around, but of course this has not happened. We cannot let this lack of preparation affect our infection control processes, which are policy for a reason, and which not following may actually contribute to community spread amongst vulnerable patient groups. The 15 minutes ‘target’ may result in a clear violation of St John’s own Infection Prevention and Control guidelines, in a climate where we are all required to wear PPE for patient facing duties.
If our members do experience a prolonged turnaround time due to compliance with St John’s own internal protocol, we suggest they record the specifics of any delay on each case sheet as an addendum in the free text section, such as ‘cleaning performed in accordance with SJA Enhanced Cleaning Procedure v1.0’. This document states (amongst other things) that ‘after every transport of a patient requiring Contract, Droplet or Airborne precautions the following must be done:
- In the case of airborne virus contamination or aerosol procedures leave the windows in the driver compartment and sliding door and rear doors of patient compartment open for 30 minutes. Cleaning can be undertaken during this time with PPE worn. Wipe frequently touched surfaces and all surfaces that may have come in contact with the patient – e.g. patient’s seat and headrest or stretcher (mattress, rails handlebars and IV stand), seat belts and buckles, reusable equipment and devices including BP cuff (according to manufacturer’s instructions), work stations and surfaces, overhead locker and drawer handles and latches.
- Thoroughly wipe all horizontal and vertical surfaces (e.g. walls, floors, ceiling and side of cupboards, front of extractor fan – located under the seat, all seats, armrests, air controls, light buttons, oxygen flow meters, switch for suction unit, button for retractable step, all door handles (inside and outside) and all yellow grab support bars) that were touched, used or have been contaminated by respiratory droplets within 2 metres (6 feet) of the patient.
- Any cupboards open during transport will require items to be disposed, if not packaged, or cleaned and the cupboard to be wiped down. Dispose of all single use and single patient use equipment in the appropriate general or clinical waste bin at the hospital.
- Follow SJWA cleaning procedures for any blood or body substance contamination.
- Dispose of used PPE and medical waste as per standard operating procedures.
- Avoid shaking the linen and dispose of at hospital collection point.
- Wipe plastic cover on pillows before applying a clean pillow case.
- Wipe down personal equipment – pens, iPads, stethoscopes, pupil pen lights, etc.
- Wipe the external surfaces and handles on all treatment bags used during patient care, including drug pouch.
- Driver compartment: Wipe steering wheel and controls, dashboard, door handles, mobile phones, handset of radio and screen of AmbiCad.
- Empty bin and dispose of content in a proper manner.
In addition to the above Infection Prevention & Control measures required by OH&S, the following factors may impact turn-around times:
– Tutoring
– Debriefing
– Colleague support
– Patient Health records/documentation
– Scheduled medication documentation
Refreshments
Where applicable, phone calls from MM-SOC ‘supporting’ you to clear should be greeted with a reminder of your obligations to ensure accurate clinical records as a Registered Health professional, and your obligations to comply with the Enhanced Cleaning Procedure v1.0 and WORKPLACE INSTRUCTION (WIAMB 23) ‘Operational Vehicle Cleaning’ March 2020.
Quick Negotiations Update
Some of you may be wondering what is happening with the EBA negotiations. We have exchanged a few letters with SJA back and forth, clarifying our position in relation to the outstanding claims. The long and short of it is that we are not moving on any of our remaining claims, and are prepared to seek arbitration with Fair Work. The main items are listed below but there are several other unresolved matters on all sides of the table.
– Definition of ‘Reasonable Overtime’ / Shift Extensions
– Paid Meal Breaks
– Restrictions on Single Officer Clinical Duties
– Pre-shift vehicle/equipment/medication checks
– Wage Increase of 2.5%, 2.5%, 2.5%
If you have any questions, please feel free to contact us on [email protected].