Interprofessional Emergency Service

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This case was submitted as part of the Call for Innovations, an annual partnership initiative between OPSI and the UAE Mohammed Bin Rashid Center for Government Innovation (MBRCGI)

A customer-friendly emergency service model from Finland where the public can find all the assistance they need at one point of service, instead of across several sites. In addition to somatic emergency services, psychiatry, substance abuse and violence prevention, crisis and social work, and child protection are available. The interprofessional model means collaboration towards a shared goal. The operational model, available anywhere in the world, improves emergency services.

Innovation Summary

Innovation Overview

The South Savo Social and Health Care Authority comprises 9 municipalities with a total population of 105,500. The population is decreasing, the rate of ageing in the region is high, and the proportion of older people is the highest in Finland. The decision was made to integrate basic healthcare, special healthcare and social services into a single functional whole in Southern Savonia. It required development of functional processes and the operational environment. The inter-professional emergency service model was developed within a project funded by the Ministry of Social Affairs and Health (2013–2016) to support functional integration. A core aim of the project was to integrate the social work and healthcare emergency services into one system. As a result, the interprofessional emergency services were implemented on 1 Jan. 2017.

In the beginning of the project, the functionality of emergency services was studied. We discovered that the customers in need of the services were scattered across the system in an impractical manner. Problems were identified in allocating services matching customers’ needs. Customers were often offered help within a medical framework, regardless of their primary service need. The results formed a basis for the structure of interprofessional emergency services.

After the analyses, actual work to design the operational model began. The work progressed in phases. An important tool in the development was an interprofessional workgroup with participants representing all emergency services players: healthcare, social services, the police, the emergency response centre and NGOs. We used Service design in the development work. To create the operating model, 2 major collaboration meetings were held in summer 2015, and an interprofessional working group met 7 times by spring 2016. The groups covered themes such as interprofessional customer situations, the core tasks of different players and the common working area, starting customer processes, crisis communication, revising experiences from the emergency service trial, and revising the draft for the model.

Between the working group meetings, the project coordinator met with different players, gathering material for the model. Meetings were also held with different working groups such as nurses from acute workgroup, emergency social workers, the team responsible for initial evaluation in child protection, and psychiatric workgroups. In addition to working with the groups, the coordinator benchmarked the 24/7 social and crisis services in Espoo and Kouvola.

Major functions that supported the drafting of the operating model were trials with an acute psychiatry nurse working on weekends (9/15) and social workers’ on-call duty on weekends (2/16). The trials facilitated customer-facing work in future operating environments, work in interprofessional pairs and testing and developing collaboration. During the trial, customer situations were monitored using interviews carried out by the duty acute psychiatry nurse, Webropol monitoring of the emergency services and evaluation meetings between those involved in the trial and their supervisors. A survey of emergency service personnel was also carried out during the pilot. The trial showed that a revised service provision changed the customer base structure that contacted the services, and the number of face-to-face meetings between customers and workers in social emergency services increased. Customers received a more complete service while the personnel felt that their work was easier and the customer service chain smoother. The operating model for emergency social and crisis work was finalised in spring 2016, and its implementation on 1 Jan. 2017 was approved by the Board of the municipal consortium on 9 June 2016. Mental health and substance abuse emergency service and child protection on-call duty during office hours were integrated into the emergency social and crisis work. The operating model responded to changes to the national act on emergency services and the section on emergency social services in the act on social welfare being drafted.

Towards the end of the project in autumn 2016, implementation of the model was supported by development meetings organised with executives in the service industry. The project coordinator also continued analysing the results of the emergency service trial, developed recording practices and communication, and implemented hands on customer work with interprofessionality in mind. As for the innovation, the model is in use. However, a lot of work is still needed before the benefits of interprofessionality can be reaped in full. The development of the model continues based on reflection with workers, monitoring KPIs and collecting customer experiences. The operating culture in emergency services is becoming interprofessional.

Innovation Description

Innovation Development

Innovation Reflections

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Year: 2017
Level of government: National/Federal government

Status:

  • Developing Proposals - turning ideas into business cases that can be assessed and acted on
  • Implementation - making the innovation happen
  • Evaluation - understanding whether the innovative initiative has delivered what was needed

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