Clinical Coordination
Coordinating medical staff work full-time in the air medical retrieval role, have a well-developed understanding of the geography of the State and the resources of referring and receiving centres. During the day we may have up to ten retrieval doctors spread over our five operating bases all handling concurrent medical advice calls or assessing flight requests. In addition, there is an experienced retrieval doctor in our Operations Centre in Perth, providing oversight to our Statewide operations and dealing with conflicting priorities which often arise.
Our communications system enables referring doctors to usually speak to the doctor who will be undertaking the retrieval flight, with only a single telephone call.
- This minimizes the number of phone calls and need for referring doctors to relay the same patient information multiple times.
- It provides an opportunity for the retrieval doctor to obtain clinical information first hand, and to discuss essential patient resuscitation and preparation with the referring doctor.
- It enables us to assign the case a priority.
- As we are ultimately responsible for the transport of patients referred to us, it ensures that our decisions regarding priority, crew mix, flight profile, special drugs and equipment, are made with the most accurate information at hand, by the most experienced person possible.
- It enables discussion with the referring doctor of alternatives to transport, and alternative transport methods, particularly if there are likely to be any delays.
- It ensures the absolute minimal delays in tasking urgent flights as the assessing medical officer is familiar with service capabilities and time-frames and is in direct communication with the coordination centre.
In most cases, referring doctors contact the receiving institution directly to arrange admission, although in urgent cases, we can arrange admission of patients to the receiving hospital. Callers are referred to relevant tertiary hospital departments for ongoing specialist advice where necessary. This is particularly the case with toxicology, cardiac, neonatal or intensive care transfers.
There is frequently a requirement to evaluate the relative merits of a mixture of concurrent requests involving obstetric, paediatric, medical and surgical cases. All RFDS medical staff are expected to have experience in obstetrics, paediatrics, anaesthetics and emergency medicine and make these judgments in an independent and non-partisan manner with due respect to the different resources available in remote settings and rural hospitals.
In contrast to other States, all aspects of the retrieval process are handled through a single agency with the call centre, retrieval staff and aircraft operator all integrated under the same roof with the same performance objectives. We also measure our response times from when the call is first received, to when the aircraft departs - not just when the pilot is tasked by an external agency. This means that all elements of the retrieval process from the customer perspective (call handling, clinical assessment, authorization, crew tasking, flight preparation) are taken into account when measuring our performance. Clinicians assessing retrieval requests are held equally accountable as the aviation staff for their timely performance. This helps minimize the delays which can be associated with hospital-based services (switchboard delays, indecision by junior staff, consultation with other staff, juggling of rosters and other committments, transport of staff to the airport).
Evacuations are coordinated on a statewide basis with any team from any base able to be tasked if necessary to achieve the most appropriate response. Likewise, airborne aircraft can be diverted when required. With an average of 120-150 emergency transfers every week, approximately 75% have destinations in Perth.