We continue to work with our partners to find new and innovative ways of improving patient care, ensuring that our patients are receiving the most appropriate care for their needs and saving ambulances for emergencies.
Over the past year we have continued to develop and expand alternate service pathways and leveraged technology to strengthen our triage capabilities.
Our Patient Management Team has made significant progress in supporting patients with frequent and complex healthcare needs while reducing strain on emergency ambulance resources.
Our work towards improving the experience of patients with mental health conditions as part of Victoria’s mental health reform program is another example of our commitment to delivering the right care to the right patient at the right time.
Video Assisted Triage
The initial success of Video Assisted Triage (VAT) has continued to grow, and the technology is now available to all Triage Practitioners across all our Secondary Triage workstations. The last year also saw the service roll out to our mental health nurses within Triage Services.
With greater visibility of our patients using VAT, we can ensure better accuracy of health outcomes, including recommending whether the patient needs to attend an emergency department.
During 2024, VAT was a finalist in both the Council of Ambulance Authorities Awards of Excellence and the Victorian Public Healthcare Awards.
Key statistics
A total of 35,092 cases managed by Triage Services utilised VAT, and 22,122 (63%) were diverted from emergency ambulance resources and referred to alternate services.
Victorian Virtual Emergency Department
As part of providing the best patient care, AV’s paramedics and triage practitioners can safely connect patients to care options, other than emergency ambulance services, that best meet their health care needs.
The Victorian Virtual Emergency Department (VVED) is one of AV’s most utilised medical telehealth services, offering patients real-time virtual consultations with emergency doctors, where they receive clinical assessments, medical advice, treatment, and appropriate referrals to services such as GPs or residential in-reach teams.
The last 12 months have also seen the service expand to offer specialist services rooms and follow-up calls to ensure continuity of care for users from the comfort of their own homes.
The expansion of VVED services, available at no cost to all Victorians via the VVED website, has continued to improve access to emergency care and alleviate the pressure on ambulance services.
Mental health reform
AV is a partner agency in delivering the Royal Commission into Victoria’s Mental Health System’s Recommendation 10, which aims to achieve a health-led response for people experiencing mental health crises.
AV has supported DH’s development of service design models and frameworks to guide progression of reform activities in 2024-25.
A Service Design Workshop series has informed system and service model design for telehealth models, health-led co-response to mental health emergencies, safe spaces and stabilisation facilities as well as opportunities for diversion of calls from police call takers to ambulance call takers.
Mental health care continues to be a major part of day-to-day work for paramedics. AV continues to engage with the DH legislation team and has completed all amendments in relation to DH/AV operational protocols. These will be finalised once there is alignment with DH and Victoria Police protocols.
Mental health emergencies
Mental health is now AV’s most frequent call type (11%), having overtaken chest pain (10%) and breathing problems (10%).
Last year, AV received 67,380 mental health calls requiring an ambulance dispatch or telephone support via Secondary Triage and a mental health clinician.
Patient Management Team
Our Patient Management Team is dedicated to supporting patients with frequent and complex healthcare needs to receive care that is tailored to their unique social and health needs.
Our team works with these patients to develop personalised patient management plans and mental health information plans, helping them to make informed decisions and link patients with appropriate care.
In 2024-25, the team created 133 new patient management and mental health information plans and reviewed 127 existing plans for tailored support and care coordination.
As a flow-on effect to implementing these plans, strain on our emergency ambulance resources is reduced, and there is a reduced risk of vicarious trauma experienced by community members assisting the patient in a perceived emergency.
Our data provides a compelling case to continue to expand our focus on patient management plans to frequent callers, members in our community who call AV more than 10 times over a three-month period. The top two per cent of frequent callers utilise 14 per cent of total emergency ambulance services. Frequent callers have also increased by 64 per cent over the past five years. This may be attributed to the 24/7 availability of ambulance services, while other services can have limited hours.
However, by identifying and treating the underlying cause of a patient’s presentations, we are able to achieve an average 74 per cent reduction in presentations in four out of five patients. These results have had a significant impact on improving patient care and ambulance availability.
Impact of patient management plans
Patient
- Increase in support services
- Reduced harm from excessive medication
- Reduced carer fatigue
- Better engagement with community supports
- Collaborative care team
AV Staff
- Supported in their clinical decision making
- Reduced occupational violence
- Reduced vexatious claims of abuse
Community
- Improved resourcing
- Reduced bystander exposure
Frequent and complex patients
The top 2% of presenters accounted for 14% of total ambulance workload.
Patients with more than 10 presentations over 3 months has increased by 64% over the past 5 years.
6 months post plan saw 74% reduction in presentations in 4 out 5 patients.
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