Muslim Hands Ambulance YEARLY REPORT 2015 KPI’s & Business Update
Contents Introduction: ................................................................................................................................................. 3 Objective: ...................................................................................................................................................... 3 How it works? ........................................................................................................................................... 4 Infrastructure Activities for Operationalizing the Project: ........................................................................... 5 Major Disasters and Untoward Events Covered since the Inception of Project: ......................................... 5 KPI’s Update: ................................................................................................................................................. 7 Comparative Analysis of Total Interventions Year 2014 – 2015: .............................................................. 7 Patient Quality Assurance Feedback: ....................................................................................................... 8 Ambulance Response Time: ...................................................................................................................... 8 Clinical Status wise Interventions: ............................................................................................................ 9 Gender wise Detail: ................................................................................................................................... 9 Patients Transfer Types:.......................................................................................................................... 10 Cost per Intervention: ............................................................................................................................. 11 Ambulances Repair Maintenance Visits to Workshop: .......................................................................... 11
Introduction: It is terms like ‘The Golden Hour’ and the ‘Platinum Ten Minutes’ that imply the importance of Emergency Medical Services (EMS) all over the world. It is a well-accepted fact that a patient who receives basic care from trained professionals and is transported to the nearest healthcare facility within 15-20 minutes of an emergency has the greatest chance of survival. EMS is an essential part of the overall healthcare system as it saves lives by providing care immediately. We are living in a time when the emphasis on preventing damage is greater than ever, the provision of pre-hospital care will be the key to ensure that the lives are not lost due to avoidable circumstances. This acute need to have emergency services in Rawalpindi/Islamabad. Muslim Hands is conceptualized to provide Emergency Response Services to people of Rawalpindi/Islamabad.
Objective: To provide comprehensive Emergency Response Services to the people of Rawalpindi/Islamabad. Improve the access to Medical & Health care, police and fire service, particularly attending emergency situations relating to pregnant women, neonates, parents of neonates, infant and children in situations of serious ill health and all other emergencies in the general population: and thereby assist the state to achieve the critical Millennium Development goals in the health sector, i.e. reduction of infant mortality rate, and maternal mortality rate, and in general reduce the vulnerability of the people by providing access to Emergency Response Services. To provide round the clock pre-hospital emergency transportation care (ambulance) services across the twin cities. The people in need belonging to the rural outskirts of District Rawalpindi and Islamabad. April 2013-Muslim Hands has launched an ambulance service for providing speedy transportation to those in need of medical assistance. The squad of 25 vehicles would be available 24/7 to assist The Specific objectives of the projects are: Stabilize and transport patients from site of injury or illness to healthcare facilities. Solve issues of access (physical and financial) and quality in-transit care. Address common emergencies such as cardiac arrest, accidents and injuries, and obstetric emergencies. 4. Reduce the incidence of loss of life due to inadequate emergency response. 1. 2. 3.
Availability of ambulances for critical patients; reliable assured and affordable transport for pregnant women and new born/infants:
All types of emergency cases are handled by MH-Ambulances, including pregnancy cases, accidental, unconscious, paralysis, inflation, fever, heart attack, and all types of emergencies. Any person in need of emergency help can dial a number of MH- Ambulance from any landline or mobile set, the ambulance reaches the site and rushes the victim to the nearest hospital with in 20 mins in urban areas. During the trip, EMT provides the victim pre-hospital care. It’s a very popular and easily available service.
How it works? The MH - Ambulance Services works on the unique paradigm of Sense – Reach – Care supported by an efficiently trained team and state-of-the-art equipment & software with GPS tracking system
Dial - 111-MHI-MHI (111- 644 -644)
Sense
Reach
Care
SENSE
Any person in need of emergency help can dial a MH – ambulance number from any landline or mobile set. This call is attended within three rings by specially trained communications officers, who after understanding the nature of emergency; connect the caller to the dispatch division.
REACH
The dispatch officer immediately identifies the ambulance nearest to the site and contacts the driver and guides him to the mishap site. Before the ambulance reaches the person in emergency, a virtual hand holding is also carried out, by putting the caller on a conference call with the Emergency Medical Technician (EMT) and/or the physician available 24/7 in the Emergency Response Centre.
CARE
The ambulance reaches the site and rushes the victim to the nearest hospital with in 20 mins in urban areas. During the trip, EMT provides the victim pre-hospital care.
Infrastructure Activities for Operationalizing the Project:
Project piloted from the twin cities of Rawalpindi/Islamabad. Provide extensive training of BLS (basic life support) to ambulance staff and build their capacity to cater and handle the emergency situation. GPS trackers installed in ambulances for exclusive monitoring from command and control system. Designed and deployed the state of art 24/7 call center with emergency helpline with capacity of 30 seated call centers. Piloted with the UAN number (hotline) 051-111 644 644. Design the SOP’s and KPI’s of ambulance project as well as the Standard Training Manual of training and refresher for the drivers and call center agents. Strategically placement of ambulances to coverage the major area of twin cities to address the timely respond in any emergencies. Meetings and MoUs signed with public and private health facilities for the well – being and increase the usage of ambulance services.
Major Disasters and Untoward Events Covered since the Inception of Project:
I-10 Fruit market Islamabad, bomb blast, 04 MH ambulances timely responded and saved many precious lives. Carried free of cost transportation to the blood donors while there was a serious emergency and shortage of blood for injured victims of bomb blast.
Vigorous response to emergency situation during Islamabad Sit – in (political protest). During Intense situation when thousands of protestors got injured and beating, firing and tear shelling from the Police, the 12 MH ambulances were fully ready, 164 people were rescued and shifted to secondary and tertiary care hospitals.
Acute response to the flood affected area of rural Islamabad (Burma Town) in the month of Sep 2014, with the support of Pak – Army; MH ambulance crews saved 100 of lives and delivered to hospital and provide first aid care in the ambulances.
Provision Primary Health Care Challenges and Quick Referral System through mobile health unit in North Waziristan TDPs operations, 03 ambulances are serving round the clock. More than 15000 individuals (Men, Women and Children) benefited from the service.
Planned effort done with Rescue 1122 and government in the Ashura days (9, 10 Moharram). Joint collaborative effort of MH and rescue 1122 ambulances in the said days and placed the ambulance strategically to avoid the duplication of both services and covered maximum area of Rawalpindi/Islamabad.
Demolition of sector I-11 slum Islamabad, violent clashes erupted between residents and authorities during anti-encroachment operation. MH emergency team provided transportation to injured victims and provided first – aid medical care.
Physically challenged people’s marathon race have conducted in Islamabad Sports Complex, MH has provided the free transportation to 35 physically challenged people from their home who were participated in the race.
Pakistan earthquake emergency response through mobile health unit. Joint collaboration with World Vision International, more than 7000 individuals has been treated in the mobile medical camps in different districts of KPK.
KPI’s Update: Comparative Analysis of Total Interventions Year 2014 – 2015: Overall month wise progress review of year 2014 & 2015 is mentioned in the graph, in 2014 total interventions were 2651, whereas the year 2015 interventions are 7865. Per month average of year 2014 was 221 patients, in 2015 per month average is 655 patients. Year 2014
Total Interventions Year 2014 - 2651 Year 2015 - 7865
Year 2015 4130
1458
1062 151 Jan
113178
151192
153168
164217
124192
124318
Feb
Mar
Apr
May
Jun
Jul
274 Aug
246213
176374
Sep
Oct
197 Nov
141 Dec
Patient Quality Assurance Feedback: MH is following continues check and balance to improve the service, for continues improvement process we have set a QA standardized benchmark which is 80%, so MH ambulance progress regarding the patient satisfaction rate is 84% in the year 2015, it has possible due to strictly compliance on rules and SOP’s. 89%
89%
QA Benchmark = 80% QA Year 2015 = 84% 85% 84%
84%
83%
84%
84%
83%
83%
82%
79%
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Ambulance Response Time: Response time is the key element in the emergency medical services, response time calculation method Response Time = (Ambulance reaching time to pick up the patient) – (Time of call for asking the ambulance). The standardized benchmark of ambulance response time is 8 minutes. While MH ambulance average response time for the year 2015 is 13 minutes & 13 seconds. Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
0:18:09 0:10:22
0:09:33
0:09:05
0:13:24
0:14:19
0:13:12
0:11:58
0:11:01
0:16:00
Benchmark time: 8 minutes Response Time : 13 minutes & 13 seconds
Dec
0:14:01
Feb
0:21:57
Jan
Clinical Status wise Interventions: The compliance on clinical protocols and segregated data according to clinical wise interventions breakdown is mentioned below; also the details of clinical status is mentioned in tabular form. Category
Clinical Status
Description
Omega
Clinical Status -3
Patient with a minor illness or injury.
Alpha
Clinical Status -3
Patient with non-serious and not life – threating situation.
Bravo
Clinical Status -2
Patient with serious but not life – threating situation which require an urgent response.
Charlie
Clinical Status -2
Patient with serious but not life – threating situation which require an immediate response.
Delta
Clinical Status -1
Patient with life threating situation other than cardiac or respiratory arrest.
Echo
Clinical Status -1
Patient who are in cardiac or respiratory arrest – critical situation.
3134 2482 1894
222
Omega
Alpha
Bravo
Charlie
96
47
Delta
Echo
Gender wise Detail: Total 7865 persons have benefited from the MH ambulance service in the year 2015 in which male patients were 3903 which is 49% and females were 3962 which is 51% of total beneficiaries. Male
Female
2258
Male = 3903 (49%) Female = 3962 (51%)
1872
833 625 85 66
Jan
94 84
107 85
98 70
112 105
Feb
Mar
Apr
May
111
Jun
194 81
124
Jul
201 73
Aug
129
275 84
Sep
99
Oct
Nov
Dec
Patients Transfer Types: Patient transfer types are the different categories which are we use to check the ambulance service demand and what purpose is serving our ambulances, there are 05 categories in which we are using the ambulances; Category 1
HOME to HOSPITAL shifting
Category 2
HOSPITAL to HOSPITAL shifting
Category 3
ROAD to HOSPITAL shifting
Category 4
HOSPITAL to HOME shifting
Category 5
Other (Dead bodies)
12%
23%
31% 21% 13%
Home to Hospital
Hospital to Hospital
Road to Hospital
Hospital to Home
Others
Cost per Intervention: The cost per intervention details (Actual Vs Charged). MH PK overall sustainability share is 13%, while 87% cost provided from MH UK. 03% sustainability is ensuring from the World Vision project – Ambulances are working in earthquake area. Actual Cost Per Intervention in PKR
Average Cost Charging Per Intervention in PKR
4709 3995
4232 3703
Sustainability: 16%
3703 3338
3277 2595 2236
778
Jan
762
Feb
904
978
800
902 430
Mar
Apr
May
1901
Jun
Jul
370
Aug
652
Sep
477
Oct
172 33
Nov
488 247
Dec
Ambulances Repair Maintenance Visits to Workshop: Monthwise segregassion of repair and maintenance visit of ambulance in year 2015. Total 287 visits in the year and average is 24 visits per month. 37
36 33
Total Visit: 287 Average per month: 24
28
25
24 21 17
18
17
19
12
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec