Work of peoples. Safe. Ambulance. edical assistance Speed Emergency First. Care. Saving Lives. Professional. Accessible. Care First.

Transcription

1 2013 Ambulance Care in the Netherlands Accurate Professional Important Quality Available Ambulance Care First Saving Lives Work of peoples Accessible TransportTran Safe Acute Care edical assistance Speed Emergency First

2 2013 Ambulance Care in the Netherlands 2

3 Ambulance care in the Netherlands Availability & emergency and ordered transport In the Netherlands, around 725 ambulances are available 24 hours a day, 7 days a week, to provide ambulance care to patients. A distinction is made between emergency transport and ordered transport. In the Netherlands, emergency transport is subdivided into type A1 and type A2 urgency. A1 urgency applies to life-threatening situations, and in such cases, the ambulance must be on site within 15 minutes of the emergency call coming in. A2 urgency applies to cases that are not life-threatening, but call for a rapid response. The ambulance must be on site as soon as possible, but no later than 30 minutes after the emergency call. Ordered transport, referred to as type B transport, is transport that can be planned, e.g. between hospitals or from a hospital to a patient s home. Facts & Figures Dutch ambulances respond approximately 1,100,400 times each year Dutch ambulances respond approximately 1,100,400 times each year The Netherlands: 41,000 square kilometres More than 16 million people Budget exceeds million euros 25 Regional Ambulance Services 207 ambulance posts Regional Ambulance Service The Regional Ambulance Service (RAV) is responsible for providing ambulance care. Within this organisation, the ambulance services and the Ambulance Care Dispatch Centre (Meldkamer Ambulancezorg) work together. Nurse-based system The ambulance care system is a nurse-based system. Ambulance nurses are licensed to administer medical treatment independently at Advanced Life Support (ALS) level. Ambulance drivers are qualified to provide medical assistance to the ambulance nurses A1 responses: approximately 500,800 A2 responses: approximately 273,700 B responses: approximately 325,900 Approximately 5,330 people work as ambulance personnel Approximately 2,220 are ambulance nurses Approximately 1,950 are drivers Approximately 410 are dispatch centre operators Approximately 750 work in or management functions National guidelines Quality levels in ambulance care are also safeguarded by means of national guidelines and protocols. Protocols represent the professional standard for the content and the process of ambulance care. In other words, care in accordance with protocols is the national standardisation of quality during the total process. Financing In the Netherlands, ambulance care is financed through premiums. That means every Dutch citizen is insured for ambulance care services by the premiums they pay for their health insurance. Financing is the domain of the insurance companies. intake leaving 6.0% 4.2% Average absence due to illness 5% 2 3

4 Twaz: an excellent stepping stone After many years of preparation, the Interim Ambulance Care Act (Twaz) was ratified by Royal Decree on 1 January This Act will be in force for a period of five years. 25 instructions In accordance with the Interim Ambulance Care Act, the Minister of Health, Welfare and Sport has given an instruction to the existing 25 Regional Ambulance Services (Regionale Ambulancevoorzieningen - RAVs). This means that these Regional Ambulance Services may provide ambulance care for the next five years. The 25 Regional Ambulance Services are proud to present their organisations in this book. A formal feather The Regional Ambulance Services have been working in accordance with the rules of the Interim Ambulance Care Act for many years. Consequently, not a great deal has changed in practical terms since 1 January We do feel though that the Twaz is a feather in our cap. Over the past few years the ambulance care sector has become very professional in the development of transport to care institutions and the provision of tailor-made care. We therefore view the ratification of the Interim Ambulance Care Act as a formal confirmation of these developments. Twaz: an excellent stepping stone The Interim Ambulance Care Act is an excellent stepping stone, but stopping here for a while is risky. We are really going to busy ourselves with the new Act that will come into force in Starting work on the new Act Ambulancezorg Nederland is already discussing the new legislation together with the Ministry of Health, Welfare and Sport and its acute care partners. Great importance is being attached to issues such as What is the positive outlook for mobile care provision? and How can we strengthen cooperation with all partners in the chain to improve patient care and assistance?. We will start working on the new act with self-confidence and enthusiasm. You will hear from us! 4 Hans Simons, Chairman, Ambulancezorg Nederland 5

5 2 2 1 CONTENTS / Groningen Friesland Drenthe IJsselland Twente Noord- en Oost- Gelderland Gelderland-Midden Gelderland-Zuid Utrecht Noord-Holland Noord Zaanstreek-Waterland Kennemerland Amsterdam-Amstelland Gooi en Vechtstreek Haaglanden Hollands Midden Rotterdam-Rijnmond Zuid-Holland Zuid Zeeland Midden- en West- Brabant Brabant-Noord Brabant-Zuid0ost Limburg-Noord Zuid-Limburg Flevoland

6 PROUD OF ,034 AmbulanceZorg Groningen carries out more than 51,000 assignments annually. Our perform every single assignment with care, no matter whether these involve emergency transport or planned transport, children or the very elderly. AmbulanceZorg Groningen is proud of its motivated, who enable it to provide effective and timely ambulance care. Bert Benthem 269 2,960 km 2 1 Getting the best out of people. GRONINGEN AmbulanceZorg Groningen is a pioneering and professional organisation intent on providing good ambulance care in cooperation with partners in the chain. Everything revolves around this desire. Whenever someone in the Netherlands dials the 112 emergency number, we think it is perfectly normal for an ambulance to arrive within 15 minutes. While this is wonderful and we are permitted to have such an expectation, it is not perfectly normal. A highly complex process makes this possible. Everything and everyone have to be perfectly coordinated with one another during that 15-minute period: technology, schedules, ambulances, communication and people in particular. Only then can we provide the care the patient requires. 1 MICU (Medical Intensive Care Unit) 38 ambulances 2 motorcycle ambulances Three core values are pivotal to our work: scrupulousness, passion and respect. These core values are reflected in our, who dedicate themselves to providing the best possible care every day. 8 9

7 ALS (Advanced Life Support) ambulances 1 ambulance bike team 1 snow scooter solo ambulances: 4 cars and 2 motorcycles 5 care ambulances 2 ambulance boats /craft The umbrella organisation RAV Fryslân, which is responsible for all ambulance care in the province of Friesland, ensures that the quality of the care provided is good and remains that way. Patients must be aware that they are in good hands all the time. Ambulances must also reach their destinations within statutory journey times. This poses a challenge in our province with its numerous lakes. Ambulance care is provided by Ambulancezorg Fryslân and Kijlstra Ambulancegroep Fryslân, which together form RAV Fryslân. Their trained and fully equipped provide assistance to those in need 24 hours a day, 7 days a week. This can be emergency transport (A1 trips), but also transport planned beforehand. RAV Fryslân is also the link to other care providers. It works closely together with the police, fire brigade, hospitals, GPs, midwives and other care organisations. They all serve the inhabitants of Friesland. 2 RAV Fryslân is a link to other care providers. 5,748 km 2 647,239 number of inhabitants in FRIESLAND The character of the northerner is visible in the identity of our : they are level-headed, modest and good at their work. They also act in the patient s interest at all times and are aware that work can always be done better. That is why RAV Fryslân devotes constant attention to innovation and training. We acknowledge the need of our to develop themselves. It is important to find a healthy balance between pressure and the ability to bear that pressure. PROUD OF... Friesland is known for its countryside and extensive lake region. It makes us especially proud that we and our can provide proper ambulance care day after day despite these geographical challenges. Sietze Kijlstra en Alie Gelissen 10 11

8 PROUD OF I m especially proud of our. Tjerk Hiddes 1 solo motorcycle 2 bike teams 3 solo ambulances 5 care ambulances 23 ALS (Advanced Life Support) ambulances UMCG Ambulancezorg provides ambulance care in the province of Drenthe. We do so 24 hours a day, 365 days a year. Our aim is to be a leading ambulance company that provides Care, with a capital C, to patients who also value this. We want to be the facilitator within the acute care chain. All our are enthusiastic by nature. We make every effort to extract as much care as possible from every euro: more care for the same amount of money. In the heart of society. We provide the best care, everywhere and on time. 480,000 number of inhabitants in 3 2,626 km 2 DRENTHE Good patient care is only possible through cooperation with partners in the chain. Technology allows us to provide top-level care. We adapt our service to the patient s needs. Knowledge becomes valuable when it is shared. Our invest in knowledge, skills and attitude. Investments must remain within budget and must result in better care. Our use the seven rights of the patient as a basis for providing care: the right to available and accessible care, the right to receive information to facilitate choice, the right to safety and quality, the right to information, consent, file creation and privacy, the right to coordination between healthcare providers, the right to an easily accessible complaints and disputes procedure, and finally the right to participate in decision-making and good governance

9 ,000 inhabitants in 28 ambulances 2 care ambulances 1 Rapid Responder 1 MICU (Mobile Intensive Care Unit) 1 medical bike number of 4 5 IJSSELLAND TWENTE 1,900 km 2 c are area PROUD OF... We are proud of what both organisations have become after numerous expansion phases. Our have remained resilient despite all the changes. It is a challenge in Overijssel to create an organisation that is ready for the future, where we still know one another by name and people enjoy their work. And above all, we are proud of this organisation and always will be! Piet Huizinga On the way to something even better, with Care. 26 ambulances 4 care ambulances 2 Rapid Responders 2 medical bikes 620,000 RAV IJsselland and Ambulance Oost work with pleasure and passion to provide more than just proper ambulance care. Contributing to (increasingly) better patient care is of paramount importance. We aim to be an excellent employer and consider cooperation with suppliers and partners in the chain a vital means for providing good and effective care. We work closely together with the cooperative Axira, GP centres and hospital departments. RAV IJsselland and Ambulance Oost both originated from various public and private 240 services. Both ambulance service regions are expected to be merged into a single organisation called Ambulance Overijssel as of 1 January The core values of our vision are: tailor-made care, at the forefront of professionalism, and provide the best ambulance care as effectively as possible. Ambulance care begins at the Dispatch Centre. Providing care for one person is the same as doing so for many. We strive to do just that bit more than what you expect of us: professional care that takes the (private) situation of the patient into consideration. We focus continuously on improving the quality of mobile care, in close cooperation with our partners in the chain. In Overijssel we are concentrating on continuous improvement, without losing sight of human relationships and a good work climate. We are realistic and levelheaded, and our carry out their work with passion and enjoyment. The focus on professional development is unique and benefits the high level of quality provided by both services. 1,500 km

10 328,000 1,788 km 2 2 motorcycles 16 ambulances 2 Rapid Responders NOORD- EN OOST- GELDERLAND ZEELAND We offer a total mobile care package. PROUD OF... I am proud of all our and the responsibility they assume to care for our patients. A great deal has changed for them in a short time since the creation of Connexxion Ambulancezorg. I am proud of everyone s cooperation and that this has been successful. I am also proud of the technical innovations in the sector that stem from the initiatives taken by our organisation. These innovations support our ambulance and chain care overall. RAV Noord- en Oost- Gelderland and RAV Zeeland are part of Connexxion Ambulancezorg. The mission of Connexxion Ambulancezorg is to provide high-quality care at a reasonable price. Connexxion Ambulancezorg is active in the regions of Noorden Oost-Gelderland, Noord- Holland Noord, Kennemerland en Zeeland. In 2011 the work 2,740 km 2 800,000 area was extended with the inclusion of the Witte Kruis in RAV Haaglanden and activities in Belgium. We perform the triage at Dispatch Centres in Zeeland and Noord- en Oost-Gelderland. In addition, we transport GPs in The Hague and Zeeland. As the sole service provider, we provide a total mobile care package. Patients can count on us for ambulance care, care ambulances and repatriation. 1 motorcycle 32 ambulances 1 Rapid Responder Our vision is founded on three cornerstones: do not react but create, use pioneering technology and be an active link in acute care. Connexxion Ambulancezorg never loses sight of its patients. Our are committed and professional. They continue developing themselves and actively contribute to improving work processes and the work environment. They do so with one objective in mind: provide patients with the best care possible! Michiel Wildschut 16 17

11 PROUD OF I am especially proud of our and the high quality of their performance. The development and use of the HAAK+ triage method specifically for the Dispatch Centre is an invaluable addition. Our training organisation makes an important contribution to the quality of our services. Ype Schat 19 ambulances 3 care ambulances 4 ambulance motorcycles 1 training ambulance 4 Rapid Responders 1,184 km 2 Our aim is to provide excellent ambulance care and actively help ensure that citizens in our region feel safe and are in good health. The aim of RAV Gelderland- Midden is to provide excellent ambulance care in close cooperation with the Dispatch Centre whilst using available resources responsibly. We want to actively help ensure that all citizens in our care area have the experience and perception of being safe and in good health. We achieve this by being a solid and reliable link in the chain of acute and escalated emergency care and through our authority within the field of acute extramural care. Finally, RAV Gelderland- Midden would like to be a pleasant and challenging organisation. 7 GELDERLAND- MIDDEN RAV Gelderland-Midden is the only ambulance care provider in the region and distinguishes itself as follows: - on-time professional care; - correct treatment of clients; - public safety for and citizens; - a proper performance for citizens; - both material and immaterial; - efficient and effective use of available resources 667, We are aware of our public responsibility. We have therefore created a clear framework of standards and values within which we challenge our to give the best of themselves. We invest significantly in the quality of our training and in the introduction of new positions, such as physician assistants and nursing specialists. Greater emphasis is also being placed on participation in scientific research within acute care. 19

12 532,000 We provide professional and proper ambulance care. Our mission involves assigning, coordinating and providing professional and proper ambulance care: effective, efficient, patient-focused, safe and geared to the actual needs of patients and partners in the chain. RAV Gelderland-Zuid, part of the South Gelderland Security Region, is focusing intently on establishing further ties between the ambulance care sector and academia. It is working in close cooperation with UMC St. Radboud to this end. In line with this, a joint, supra-regional training office has been established together with RAV Gelderland-Midden. 1,040 km 2 RAV Gelderland-Zuid is a professional care organisation with dedicated trained in accordance with national standards. We are an active partner in the emergency care chain and in the provision of medical assistance during accidents and disasters. Our Regional Ambulance Service is an innovative and resultoriented care facility intent on being a reliable employer. We work according to a transparent management process and with verifiable operational results GELDERLAND- ZUID Our Regional Ambulance Service adheres to the same standards and values used by most other services. Our culture of sport and leisure makes our organisation unique. In addition to our work, we participate in annual sports events such as the Zevenheuvelenloop and Marikenloop road running races. We also organise other sporting activities such as a sailing weekend or a skiing holiday. One striking aspect of our identity is the considerable attention and support that colleagues give to those among their ranks who are ill and their families. 1 MICU (Mobile Intensive Care Unit) 17 ambulances 3 reserve ambulances 2 Rapid Responder motorcycles 2 Rapid Responder cars 3 care ambulances PROUD OF... I am proud of our cooperation with UMC St. Radboud to develop a nationwide medical and scientific research programme. I am also proud of our supra-regional training office we established together with RAV Gelderland-Midden. This office trains ambulance, GPs and midwives using advanced teaching methods. Mac Honigh 20 21

13 1,200,000 9 UTRECHT 427 1,449 km 2 RAVU embraces four core values: proper mutual collaboration with openness and respect for the other, a high degree of involvement in the organisation and the work we do, demonstrable professionalism in our actions through periodic training, evaluation and supervision, and finally a result-oriented way of working according to the principle do it properly the first time, which is beneficial to the patient as well as the organisation. Quality and patient safety are a major priority for us. RAVU provides ambulance care and (emergency) chain care of a high quality. Patients can therefore rest assured that they will receive care that is safe and provided in line with the latest thinking. RAVU therefore imposes strict requirements on the skills, knowledge and training of its. RAVU helps improve the knowledge and performance level of ambulance care by participating in scientific research and publishing its findings. RAVU s core task involves providing proper ambulance care geared to the patient. This core task is supported by two important pillars that contribute significantly to the quality of ambulance care, namely training and research. Our specialist, the use of high-quality resources and materials and sound management allow us to provide proper ambulance. 46 ambulances 21 Rapid Responders (cars, motorcycles, bicycles) 2 MICUs (Mobile Intensive Care Units) PROUD OF... The commitment and professionalism of our. Thanks to them we can provide high-quality care 24 hours a day. Winning the highest INK Award (five stars) demonstrates this wonderfully. Jack Versluis 22 23

14 2 motorcycles 26 ambulances 1 Rapid Responder We want to be an active link in the acute care sector. 650,000 RAV Noord-Holland Noord provides high-quality ambulance care by focusing on the patient and cooperating closely with partners in the acute care chain. RAV Noord- Holland Noord can go beyond its limits time and again by innovating continuously. RAV Noord-Holland Noord comprises two ambulance service providers: the Noord- Holland Security Region and Connexxion Ambulancezorg. These two providers have jointly established the cooperative Ambulance Care Association for Vereniging Ambulancezorg Regio Noord- Holland Noord. Close cooperation between these ambulance services and the Ambulance Dispatch Centre allows this Regional Ambulance Service to provide high-quality and effective ambulance care to everyone in the Noord-Holland Noord region NOORD- HOLLAND NOORD Our vision is founded on three cornerstones: do not react but create, use pioneering technology and be an active link in the acute care chain. We achieve this by investing in a positive working climate, in technological developments and in professionalism. Our have an eye for improvements and innovations. They are aware that proper care can only be provided in close coordination with partners in the chain. That is why we make binding agreements with healthcare insurers and work together with partners in the care sector, public order and safety, and public administration. We have concluded performance agreements with the Ambulance Dispatch Centre of the Noord-Holland Noord Security Region. PROUD OF... We are proud of the effective cooperation with our partners in the chain involving the exchange of medical information. Of course we are also proud of the two awards we won: the 2010 Public Safety Award and the 2012 Safe Public Task Award. 1,350 km 2 Martin Smeekes (above) and Michiel Wildschut (below) 24 25

15 1,300, ZAANSTREEK- WATERLAND 13 AMSTERDAM- AMSTELLAND 813 km MICU (Mobile Intensive Care Unit) 58 ambulances 8 care ambulances 2 Special Care ambulances 2 Rapid Responder PROUD OF... We are proud of the fact that we succeeded in establishing a good cooperation with our partners in the chain. A specific result is our ability to constantly provide better high-quality ambulance care. Jan Pierik Ambulance Amsterdam is the number one provider of ambulance care in Amsterdam- Amstelland/Zaanstreek- Waterland. Everyone can count on receiving good ambulance care from us that is personal and provided on time. Our focus is on care quality, which is stimulated partly by our ties with the Academic Medical Centre (AMC). 426 We are responsible for providing this ambulance care 24 hours a day, including during (the threat of) largescale accidents and disasters. We seek alliances to ensure integrated acute care in the trauma regions of northwestern Netherlands. Our partners in the care and safety chain consider us reliable and supportive, and believe we play a connecting role. Care with head and heart. Care in combination with mobility defines our identity. We wish to provide various types of mobile care, adapted to the needs of society. We do this on our own or in partnership. Our aim is to take care of the logistical coordination of all mobile care from the Dispatch Centre. Openness, focus and dialogue, with appreciation for one another and attention for human aspects are the distinguishing features of our organisation. 27

16 PROUD OF... I am proud of two things as board chairman of RAV Kennemerland. The first is the constructive cooperation between the directors of the three transport organisations within RAV Kennemerland. The second, naturally, is the fact that we have been the fastest Regional Ambulance Service in the Netherlands for many years. Our response time is the shortest of the year and we also have the quickest Dispatch Centre time. 525, km 2 12 KENNEMERLAND We provide high-quality ambulance care. Frans Schippers 2 bicycles 3 motorcycles 22 ambulances 2 care ambulances RAV Kennemerland provides high-quality ambulance care to all patients entrusted to it. That is our mission. RAV Kennemerland is a cooperative that was established on 30 November 2011 and comprises the Kennemerland Security Region (GGD Ambulancezorg and Ambulance Dispatch Centre), Connexxion Ambulancezorg and Ambulance Amsterdam- Kennemerland. We are not only a leading ambulance care provider but also an active and reliable partner in the chain with other acute care providers and for disaster response and crisis management. RAV Kennemerland is investing in a positive working climate and in professional competence. Effective training and attractive career opportunities motivate and bind them to our organisation. Ambulance care is provided by competent and motivated who focus not only on patients but also on innovations and improvements. Proper ambulance care is impossible without close cooperation and coordination with partners in the chain when providing day-to-day and large-scale assistance. Three ambulance transport providers work together within RAV Kennemerland. We focus strongly on cooperation while retaining the best aspects of everyone s respective culture. This applies not only within the Regional Ambulance Service, but also with partners in the acute care chain. The aim of this binding factor is to provide high-quality ambulance care

17 PROUD OF ,42 km 2 30 I am proud that we are a solid and financially sound organisation despite being the smallest Regional Ambulance Service. Our limited size also offers benefits; Lines are short and everyone knows one another. Our are therefore highly committed and motivated. We have a young vehicle fleet fitted with the latest equipment, including the AutoPulse. The delay percentage, which is already low in our region, is still decreasing every year. René Ton 245, ambulances 2 Rapid Responders/ Medical Duty Officer 72 We provide our patients with good care. 14 GOOI EN VECHTSTREEK RAV Gooi and Vechtstreek provides high-quality ambulance care and is a strong and reliable partner in the (acute) care chain. We are the smallest Regional Ambulance Service in the Netherlands; Despite our limited size, we are a solid organisation and can therefore offer high-quality care. We also organise refresher courses and in-service training for our own and those of our partners in the chain. We can set high standards because our are competent and our equipment meets the most modern requirements. Innovation and cooperation ensure that our organisation focuses continuously on optimising the services its provides. Spreading our potential enables quick response times. We have made structural cooperation agreements with the GP network, hospitals and the mental health care services (GGZ), and maintain excellent partnerships with emergency services. We are a reliable organisation in terms of governance and finance. Our core values are: being reliable, caring and professional. Our limited size means that lines are short and everyone knows one another. We are a dependable care provider for all patients entrusted to our care. Our professional attitude guarantees outstanding ambulance care. Our patients are our key focus. 31

18 km 2 1,026,469 RAV Haaglanden provides high-quality, safe and proper ambulance care to all patients entrusted to it. RAV Haaglanden is a cooperative association established by Ambulancezorg Zoetermeer, Ambulancedienst GGD Den Haag and Witte Kruis Ambulancezorg. We have concluded an SLA with the Ambulance Dispatch Centre of the Haaglanden Security Region. We are an active and reliable partner in the chain with other providers of acute care and for disaster response and crisis management. Good cooperation ensures high-quality ambulance care. In addition, we work together with other partners in the care sector, public order and safety, and public administration. Our aim is to provide a high level of quality and continuously improve the care we provide. Excellent coordination between the three ambulance services and the Ambulance Dispatch Centre allows us to provide both high-quality and effective ambulance care to everyone in the Haaglanden region. 36 ambulances 9 care ambulances 2 Rapid Responder cars 4 Rapid Responder motorcycles 15 HAAGLANDEN Our are professional and motivated. They focus not only on patients but also on innovations and improvements. The different organisations within our cooperative work closely together. Our organisation invests in a positive working climate and professional competence. We carry out our tasks in a transparent manner and use available resources as efficiently and effectively as possible. PROUD OF... I am exceptionally proud of the constructive cooperation within our organisation. This allows us to combine processes, which benefits patient care directly. We are busy optimising our readiness schedule to ensure our remain within the standard response time as much as possible. I am also proud of the cooperation with partners in the chain involving the exchange of medical information. Ton van Egmond 32 33

19 PROUD OF... Our organisation has implemented various innovations in the past few years. That fills me with pride. Examples of these innovations are the LUCAS in 2006, the Coronary Open Programme in 2007, the bone drill in 2008, the CPAP mask in 2009, the Larynx mask in 2010, a protocolled Dispatch Centre system (ProQA) in 2011, the Brain Open Programme in 2012 and the Direct Deployment of Ambulances (DIA) in Pieter Haasbeek HOLLANDS MIDDEN 766, km 2 RAV Hollands Midden is a professional and transparent organisation. This creates a solid foundation for an environment where every opportunity to improve care is utilised. Taking a critical look at yourself and learning from (potential) mistakes in all organisational layers helps improve care continuously. 31 ambulances 1 ambulance with special functions: transport of two incubators, mother together with incubator, bariatric patients RAV Hollands Midden provides proper ambulance care in a professional, innovative and transparent manner. We are a modern, pioneering organisation. Providing stateof-the-art ambulance care is a task we enjoy undertaking. We have created a modern training centre (for simulation teaching and e-learning) for this purpose. Furthermore, we work together with Traumacentrum West- Nederland. We also participate in scientific research. Our intensive cooperation with partners in the acute care chain ensures that patients can immediately receive the best possible treatment in the right place. The National Ambulance Museum is also situated at our headquarters in Leiden. RAV Hollands Midden attaches great importance to a professional working climate. Top-quality training and scientific research in ambulance care help make this possible. The care we provide is therefore safe, responsible and accurate, allowing us to be a strong link in the chain and in escalated emergency care. We are a socially responsible organisation and want to actively involve the patient in our work. Good ambulance care saves lives. That is what we strive for! 34 35

20 Professionalism in acute care is something you achieve together. 17 ROTTERDAM- 2 MICUs (Mobile Intensive Care Units) 8 Rapid Responder 61 ambulances 8 care ambulances 60 trailers (35+25) 5 motorcycle ambulances 1 Lifeliner trauma helicopter/ Mobile Medical Team AZRR provides proper care in the Rotterdam-Rijnmond region, in close consultation with all relevant parties. Available resources are used as efficiently as possible to this end. An additional Ambulance Care Dispatch Centre has been established to also provide timely ambulance care at the Maasvlakte site. AZRR provides its services in close cooperation with partners in the acute care chain as well as partners involved in public order and safety. Mutual respect for one another s competencies is an important pillar in this respect. Progress, growth and success require cooperation and continuous organisational improvement. 856,2 km RIJNMOND Acting swiftly and professionally is the priority of all our. We achieve professionalism by working together. Transparency is essential in this respect, both among and vis-à-vis patients and our partners. PROUD OF... 1,200,000 Our region is very diverse. I am proud that our can provide good ambulance care in all these different areas, including large urban areas, the countryside and the industrial port area. Our dispatch centre at the Maasvlakte site is a fine example of this. Rein van Duijvenbode 36 37

21 PROUD OF... We have invested in our own training centre for years and our attend courses here regularly. The knowledge and skills of our are therefore of an exceptionally high level, which is a source of pride for me. Another point of pride for me: we have been seconding nurses to chain partners for years now, such as the Dutch Urban Search and Rescue Team (USAR) and the Mobile Medical Team (Lifeliner 2 trauma helicopter). Jan Nieuwenhuis 483,000 5 bicycles 15 ambulances 3 care ambulances 1 Rapid Responder car 836 km 2 Honest, flexible and committed. RAV Zuid-Holland Zuid is a transparent care institution with professional who provide high-quality (ambulance) care. We work together in the care and public safety chains. Our organisation distinguishes itself thanks to the following characteristics: integrity, flexibility, innovativeness and ZUID-HOLLAND ZUID involvement with the people and (care) organisations in our work area. These characteristics are vital given that we work in an expansive region with considerable differences. This mission statement was formulated very recently and clearly indicates where the emphasis lies for RAV Zuid- Holland Zuid. We focus on high-quality ambulance care by investing significantly in the training and supervision of our professionals. That applies to nurses, drivers, carers, Dispatch Centre operators as well as everyone in support functions. Together we ensure that all our work area receive top-quality care. Professionalism, integrity and transparency are the most important characteristics of our organisation. The professionalism of our enables them to work independently in conditions that are often difficult. They are not afraid to discuss their actions and are transparent, even when in doubt. They are therefore honest professionals whose tremendous commitment to patients allows them to contribute significantly to society

22 3,654 km 2 1,725,905 RAV Brabant Midden-West- Noord provides acute care and ambulance transport for 46 municipalities in the province of Brabant. We work closely together with partners in the chain such as hospitals, GPs, midwives, the fire brigade and the police. Our professional first responders are on standby 24 hours a day, 7 days a week to provide medical assistance and Acute care on time and on site. to transport patients quickly and safely. Our organisation was created following a merger between five public and five private services and serves two Security Regions with two Shared Dispatch Centres. Patients come first above all else.they are our clients and have the highest priority. We also believe it is important to be a dependable and respectful partner for all parties involved.because we perform a public duty, we strive to be completely transparent in our actions. In doing so we demonstrate to everyone that we handle the government funds provided to us in a responsible manner MIDDEN- EN WEST- BRABANT 21 BRABANT-NOORD For our employees it is all about commitment. Commitment to their patients, to one another and to the company. Our organisation s dynamic and healthy working environment gives our ample opportunities for self-development. We have deliberately chosen a coaching management style to encourage a proactive, responsible attitude among and stimulate their personal development. 48 ambulances 6 care ambulances 6 Rapid Responder cars PROUD OF... I am proud that our Regional Ambulance Service has grown, following the merger, into a financially healthy company that focuses on the development of our and on innovation. We use the digital trip form and our care ambulances are equipped with Stryker Power-LOAD stretchers. We were also the first ambulance service in the Netherlands to start the Hart4All pilot that brings together rescuers who have administered CPR and the people they saved. Ger Jacobs 40 41

23 PROUD OF... I am proud of our and the good cooperation with our partners in the chain. Concrete examples I m proud of include: the FIC block pilot, our performance in reducing delays, the training of First Responders and our innovative e-learning partnership with other regions (Doczero). Marc van Aken BRABANT- ZUIDOOST 742,000 4 care ambulances 25 ALS (Advanced Life Support) ambulances 2 Rapid Responders 1,458 km 2 RAV Brabant-Zuidoost provides proper, professional ambulance care to patients in our region using resources of the highest quality. Our organisation is a partnership between the South-East Brabant Municipal Health Service and Ambulance Dispatch Centre and the South- East Brabant Security Region. Good triage, effective logistics management, care differentiation and the efficient deployment of and resources ensure that our patients come first. RAV Brabant Zuidoost aims to provide proper, tailor-made ambulance care at the agreed moment and/or as quickly as possible. The care we provide is perfectly in line with the care offered by partners in the chain. We provide tailor-made care, with respect for our patients. We provide ambulance care that meets the following quality requirements: available and accessible, professional, of a high quality and safe. Our organisation is efficient and complies with the requirements of good governance and good employership. Our work in a transparent manner and respects patients privacy. We assess customer satisfaction and have an adequate complaints procedure. Our organisation also allows clients to participate in decisionmaking

24 PROUD OF... I am proud that various initiatives are already responding to the increased demand for care and the shortage of care in the future. Among these initiatives are three care concepts we are developing with different partners: the Acute Zorgplein, a pilot involving the provision of unplanned care and cooperation with a care centre to our care ambulance. Tjerk Hiddes (r) en André Lemmen (l) 515,828 3 planned-transport ambulances 4 medical bikes 1 care ambulance 2 solo ambulances 25 ambulances Care on the move. The main task of AmbulanceZorg Limburg- Noord is to provide emergency, medical assistance at the right time throughout the region of North Limburg. Our ongoing aim is to optimise this task by working together with partners within and outside the sector. Our AXIRA cooperative is a vital innovation testing ground within the sector. 1,521 km 2 23 LIMBURG- NOORD Outside the sector, in addition to the fire brigade and the police, our organisation is a key partner within the North Limburg Security Region, serving it with a shared Dispatch Centre and providing medical assistance for dealing and managing disasters and crisis situations. AmbulanceZorg Limburg- Noord is involved in developments in society and aims for performance through innovation. As a progressive ambulance service, we opt to join forces with other organisations on different levels. We find partners within and outside the sector to help us attain our goals. We wish to use our knowledge and 191 experience to improve care for citizens in the (local) care landscape. Every year over 30,000 patients are entrusted to our care. Our aim is assist them as best we can. In other words, in safety. The quality of care begins with the quality of. We attach importance not only to technical skills but also to the attitude and behaviour of our. We have jointly defined our core competencies: cooperation, self-development, self-discipline and qualitymindedness. Our management focuses systematically on the development of these competencies and this is also reflected in our culture as a learning organisation

25 660,56 km ZUID- LIMBURG 607,000 1 medical intensive care unit (MICU) 25 ambulances 2 care ambulances 4 Rapid Responder motorcycles 4 Rapid Responder cars RAV Zuid-Limburg is a dependable and professional partner in the chain of acute care that gives top priority to providing the best possible assistance to citizens in our region. South Limburg has a long history of acute care and patient transport. Even as early as 4 A.D., Saint Designatus saved and resuscitated three knights who had fallen into the River Meuse. After the Emma mine disaster in 1911, the Netherlands fourth ambulance was deployed in this region. Our organisation is therefore based on a long tradition, but has moved with the times. We are a dependable partner in the acute care chain, within the Netherlands as well as in the border region with Germany and Belgium. We believe that cooperation with partners in the chain must not be impeded by organisational boundaries. Close, cross-border cooperation with neighbouring regions in surrounding countries is also important. Agreements have been laid down in Eumed Euregio Meuse-Rhine for this crossborder ambulance care that is vital for South Limburg. Unfortunately a Euregio without borders does not exist yet. That is why ambulance care without borders is our aim! There was a time when the main equipment onboard a South Limburg ambulance was additional oxygen, a small container filled with holy water and a rosary. Despite the limited resources at their disposal, first responders did all they could for patients. That mentality has not changed. Providing the best possible assistance to patients is still the norm. Our first responders are perfectly aware that this helps maintain or improve someone s health. PROUD OF... I am proud of all our Regional Ambulance Service. High-quality ambulance care is impossible without their professionalism and tremendous drive to help people. They are constantly innovating and improving. The South Limburg Ambulance Dispatch Centre was the first to introduce the Dutch Triage Standard in December 2012, for example. Frank Klaassen 46 Ambulance care without borders. 47

26 PROUD OF... 2,412 km 2 I am exceptionally proud of the profound commitment of our and the quality of the care we provide in a region with significant geographical differences. The challenge to provide good ambulance care in the countryside as well as urban regions is being tackled effectively. I am also proud of our cooperation within the acute care chain. Cees Verdam ambulances 3 Rapid Responder RAV Flevoland provides high-quality and professional ambulance care. Our core values are reliability and professionalism. Our organisation, which is a young service in the youngest province of the Netherlands, is growing continuously and embedded within the Flevoland Municipal Health Service. We are a prominent partner in the acute care chain. 25 FLEVOLAND Our organisation aims to provide high-quality ambulance care by continuing to innovate and optimise cooperation with partners in the chain. We strive for transparency in our work and sound communication with our partners and patients in our region. Doing so allows us to create a solid organisation that is reliable, efficient and effective. Thinking pragmatically and focusing on action! 398,250 We are focused on the future. Our patients are our main concern. All our efforts are aimed at optimising the assistance we provide. We endeavour to ensure that greatest possible satisfaction among our patients. Our organisational culture is characterised by a no-nonsense approach, a willingness to roll up our sleeves and get down to work, thinking pragmatically and focusing on action! 48 49

27 Situated in Zwolle 15 Ambulancezorg Nederland (AZN) is the sector organisation for ambulance care. AZN promotes the interests of the Regional Ambulance Services (RAVs) affiliated to it. Hans Simons is the chairman of AZN. In addition to advocacy, AZN offers different types of support to RAVs and their professionals, and safeguards the sector s image. Ambulancezorg Nederland is supported by its office ed by 15 people, including Director Koos Reumer. Since

28 Publication details Text Regional Ambulance Services (RAV s) Editorial board Nadiene Toby, Ambulancezorg Nederland Translation Balance BV Design Vormix and Y. de Groot, P. van Dorst Printing HSGB 52

29 act 5 years 25 instructions RAV S (Regional Ambulance Services) 01 Groningen 02 Friesland 03 Drenthe 04 IJsselland 05 Twente 06 Noord- en Oost- Gelderland 07 Gelderland-Midden 08 Gelderland-Zuid 09 Utrecht 10 Noord-Holland Noord 11 Zaanstreek-Waterland 12 Kennemerland 13 Amsterdam-Amstelland 14 Gooi en Vechtstreek 15 Haaglanden 16 Hollands Midden 17 Rotterdam-Rijnmond 18 Zuid-Holland Zuid 19 Zeeland 20 Midden- en West- Brabant 21 Brabant-Noord 22 Brabant-Zuidoost 23 Limburg-Noord 24 Zuid-Limburg 25 Flevoland