SA Virtual Care Service (SAVCS) was set up for emergency department trained clinicians to work directly with SA Ambulance Service (SAAS) paramedics via video link to assess patients onsite, with the aim of reducing hospital transfers.
To develop an evidence-based implementation plan for the service, SAVCS’s Evaluation Manager, Phillip De Bondi applied for the Aged Care Research and Industry Innovation Australia (ARIIA) Innovator Training Program in July 2022.
“The ARIIA program team encouraged me to approach the project in a way that considered all the stakeholders, objectives and evidence. Using evidence to inform the project, I was able to build a strong business case that highlighted the many benefits of the service to these stakeholders,” said Phillip.
“Our data showed that approximately 16% of all SAAS referrals came from Residential Aged Care Facilities (RACF). We saw that they often had significant delays waiting for transport to the hospital, waiting at the hospital, and waiting to be transported back home,” he said.
“Evidence from the 2019 Royal Commission into Aged Care showed that thousands of similar inappropriate ‘000’ calls come from RACF, and residents do not always achieve good outcomes by attending a hospital.”
“They are more likely to develop further health problems, including new pressure ulcers, gastrointestinal and respiratory tract infections, and they can experience greater functional impairment.”
“We saw an opportunity to provide direct access to our 24-hour virtual emergency care instead of calling for an ambulance, and upskilling aged care staff to build their confidence in calling the SAVCS.”
"Residential aged care staff, who possess the best knowledge of the residents, play a pivotal role in utilising our service. It's crucial to ensure they are well-informed about SAVCS, know when and how to call us instead of an ambulance, and can facilitate family and friends' participation in the calls. Their active engagement and confidence in our service are crucial," said Phillip.
Since it was launched in December 2021, 80% of South Australian residential aged care providers have registered to use the SAVCS, and more than half have used the service.
Through positive patient and clinician feedback, Philip noted that care outcomes have been exceptional since the service started.
“To date the service has coordinated more than 1,400 virtual consults with RACF residents across South Australia. More than 80% of these calls have resulted in the resident avoiding the emergency department and more than half received care in their place of residence, saving time and reducing risks.”
“The median call time is 43 minutes, so we know that the service is a significant time saving for staff from the usual ambulance call and wait, resident preparation, family co-ordination, and post transport complications. Residents also avoid long delays and unnecessary risks to their health and wellbeing,” said Phillip.
"One great example is a daughter's mother who had a virtual consult at her residential care facility, with her husband joining the video call from their farm. SAVCS streamlined a typically time-consuming and stressful situation, resolving it swiftly and safely."
“Our priority now is to build awareness among more healthcare facilities and staff, encouraging nurses and care workers to incorporate SAVCS into their resident assessments. We are also collaborating with partners to enhance the skills of RACF nurses and provide opportunities for them to gain experience in acute assessment. SAVCS stands out with its unique feature of direct interaction between onsite referring clinicians and our specialist clinicians."