Ambulance Victoria

From Risk Diagnosis to Cure

A proactive approach to system improvement

“The whole certification program has to be seen as value add, or people will question why we have it. It’s not about just getting a certificate, it’s really about business excellence.” David Bugeja, Service Quality and Improvements Manager, Ambulance Victoria

Ambulance Victoria has been fully certified to both AS4801: 2001 and ISO9001 at a statewide level since 2009. David Bugeja explains how his team ensures the certification program is seen as an essential insight into the organisation rather than a simple checklist audit.

Ambulance Victoria was established on 1 July 2008 as a result of a merger of Rural Ambulance Victoria, the Metropolitan Ambulance Service and the Alexandra District Ambulance Service. This resulted in the establishment of a statewide service providing pre-hospital care for patients experiencing medical emergencies, and medical transport by road and air to ensure both emergency and non-emergency patients access the appropriate level of health care.

The former complex organisations had different policies, procedures and processes for managing the unique risks involved in patient care. The first challenge was to develop a standardised statewide operation, covering about 200 rural and metro ambulance branches as well as major business centres at Doncaster, South Melbourne and Burwood.

“Achieving statewide certification was a major milestone for the organisation,” David explains. “We needed to demonstrate to staff and management that quality and safety certification could bring real benefits, and this required a high level of commitment from the Executive and the Board of Directors.”

Three years on, David has made significant changes to the approach his team of four takes with the program, as they continue to maintain certification through NCSI. “Certification is not a one off exercise, it’s a constant review and improvement process,” he says. “There are still areas where improvement is possible and we work proactively with line managers to ensure we not only continue to comply, we exceed and improve on the requirements where practicable.”

A value add approach to auditing

David explains that while internal audits are usually focused on compliance, at Ambulance Victoria they place a greater emphasis on auditing the full process. “This provides Managers with greater insight and value”.
“We prefer to call it ‘conducting a review’, not an audit. We look at the end to end process, and provide management with a high quality report and findings. We highlight gaps, risks and opportunities. It’s more like a high quality piece of internal consulting work that gives Managers valuable insights into their processes.”

To ensure this internal approach is seamless with their external requirements, David’s team works closely with NCSI and other assurance bodies, such as PricewaterhouseCoopers, to avoid the risk of duplication and ensure an integrated audit approach. In the past, David’s team might have conducted up to 50 one-page checklist audits a year. Now they conduct up to 14 reviews and audits that focus on a deep-dive insight into a specific process.
“We would rather do 14 or so in depth process reviews that give real insights to management than 50 checklist audits with no actionable points or value add findings,” says David.

As a result of a recent review of his team David has now recruited a process improvement specialist. This means that the team can now actively support managers in addressing any non conformances through the design of solutions.
“Some managers don’t have that capability or skill set. They may understand and be aware of the problem but they may not have the specialist skills to go about fixing it.”

“We have also been very active in working closely with operational managers to ensure policies and procedures are reviewed and updated to reflect the statewide service. This is important not only from a risk perspective but to ensure good governance”.

Continual improvements create confidence

“Our reviews are about value add and insight. Without question that has been a major factor in internal acceptance of the certification program,” says David. “Managers have confidence in our work and now seek us out for assistance with their process improvement challenges.”

By demonstrating the value of certification, his team can provide tangible benefits to the organisation, give managers confidence in the operational practices and assure stakeholders that the processes are compliant with best practice standards.

“It’s a way of extending the value of the certification program from sheer compliance and checklist auditing to reviews and audits that give you deeper insights into processes. That’s what managers really want. They want to know what’s working, what isn’t going well, and what are the risks and issues.

“We’re not just identifying problems and giving advice. We roll up our sleeves and help out.”
And in looking deeply into the whole health of the system, they provide confidence and reassurance to the staff of Ambulance Victoria, as well as to the people and communities that our paramedics serve day and night.

Useful Information:

To find more information about the Ambulance Victoria visit: http://www.ambulance.vic.gov.au/

For more information on how NCS International can assist you with your certification, call 1300 856 554 or

Request a Quote Online.