I need you to do Assignments!

This project is designed to evaluate the response time in Saudi Red Crescent Authority (SRCA) in Riyadh, which is the capital city in Saudi Arabia.

It has a full description about what we did in order to get everything done.

First part:

This part is about the agency description and stakeholders. We looked at the agency and we defined its vision, goals, and objectives. We also got their population, Demographics, geographic, social economic, resources, Personnel, Instruction of the agency, Facilities and equipment, Incidence, Hospitals, Professions, Standards, Similar agencies, Stellar, Agency legal, Activities, Output, and goal.

Second part:

This part is about focusing the design of the evaluation. We defined the reasons behind this evaluation. We also defined the barriers and propellers, assess effects, key stakeholders, instrument we used to gain the information, and some findings.

Third Section:

In this section we started planning. We got need assessment such as; Epidemiology, agency’s needs and wants, agency issues, and target population needs and wants. We also used an instrument to gather the information we needed and we got some findings about that.

Forth section:

In this section we looked at similar agencies in different countries, we looked at what they did with improving the response time and we defined three ways from different agencies to see in the end how are doing in this project. In addition, we defined predisposing, reinforcing, and enabling factors (P.E.R) of the agency, and then we decided which ones the important factors that we should focus on.

Fifth section:

In this section we completed doing the planning part. We defined the program objectives as well as the interventions; such as Education, engineering, policy, environmental, and engineering. Then we defined the relationship between the interventions and the P.E.R factors.

Sixth section:

In this Section we completed doing the planning part as well. We did a logic model. We also defined many things such as; buy-in, budget, marketing, as well as PERT Chart.

Final Section:

In this section, we did more detailed evaluation for everything we have done.

1

•Saudi Red Crescent Authorities Vision and services:

“The Saudi Red Crescent Authorities offers emergent and fast medical service of first aid with a skill and effective result for citizens and foreign labors that are staying in the kingdom in ordinary circumstances and at time of catastrophes. It also contributes on enhancing standard of medical knowledge level .The Authority contributes on relief works inside the Kingdom and abroad. It offers service according to Islamic morals and instructions. It works in basic authentic medical regulations. It`s devotion on showing prominent human role and making strong friendly relations with public and government authorities which has relations with the activity of the authority inside the kingdom and abroad. The Saudi Red Crescent Authority gives the working staff special attention by training them and giving them incentives and facilities.”

· Goals and Objectives

· Storage, shelter, medicines, and all what is needed to treat the sick and wounded prisoners and care.

· Provide the necessary immediate first aid to the victims of accidents, disasters and calamities public.

· Transport the sick and injured in accidents and contribute to the treatment and to participate in the fight against epidemics and provide medical services and to participate in the dissemination of culture, health, construction and management of hospitals, clinics and pharmacies, clinics and aid stations and blood transfusions.

· Provision of health services and medical assistance to the pilgrims and health care in cooperation with the competent departments.

· The advancement of the nursing profession and work to measure nurses, and trained on the work of hospitals and emergency as well as specialists, social workers and others who need them to achieve their purposes, whether they are full-time or volunteer, and this is particularly either training courses or create schools ambulance, nursing or assistance in the establishment.

· Insurance of first aid at the scene and transport the sick and injured to treatment centers.

· Contribute to the humanitarian and social services consistent message and Red Crescent Societies.

· Publication of the purposes and principles of the Red Crescent humanitarian.

· Closer relations and the exchange of aid possible between them and the Crescent Societies and the International Red Cross and other similar bodies.

· Population is 5700000 people.

· 61٪ Residents

· 39% Foreigners

· Special population/ target audience:

· Pilgrimage: (5 days period every year)

· At least 4000 rescues presented in pilgrimage.

· Each rescue that participates in pilgrimage will get double salary.

· More than 3000 calls in this period.

· Diabetes Cases.

· High Blood Pressure Cases.

· Car accidents Cases.

· Demographics

· Age:

· 35% 0-14 years.

· 60% 15-59 years.

· 5% 60 years and over.

· Gender:

· 52% Saudi males.

· 48% Saudi females.

· 69% Foreigners males.

· 31% Foreigners females.

· Geographic:

· Who do they serve?

· The whole city

· Socio economics

· The service is 100% free for residents and Foreigners who work for residents.

· Foreigners who work for companies should have health insurance.

· Users Questions:

· How can we improve the response time?

· How can we avoid the crowed in streets?

· What are the best ways to educate city residents to help ambulances to pass them in streets?

· Should we force policemen to be EMT certified so they can provide the care if they reach before EMTs.

· Should we teach EMTs other languages beside mother language to help all nationalities?

· Resources:

· Agency budget: 506625500.00 US Dollar.

· Emergency Medical Services: ~ 200 million US dollar.

· Personnel:

· Agency: ~ 50000 employees

· Rescues: ~ 10000 recues

· Instruction of the agency:

· Director of Saudi Red Crescent Authority

· Assistant Director of Technical Affairs

· Assistant Director of Administrative Affairs

· Departments’ directors

· Physicians

· Paramedics

· EMTs

· EMTs Assistance

· Drivers

· Facilities and equipment of Saudi Red Crescent in Riyadh:

· Each station has at least 2 ambulances.

· Each station has a medical supply room.

· Incidence:

· Weekdays they get 300-400 calls

· Weekends they get 500-600 calls

· Hospitals:

· 39 hospitals.

· Professions:

· Medicine degrees.

· Master of science of emergency management.

· Bachelor science of emergency medical services.

· Paramedic degrees.

· EMT Advance degrees.

· EMT Basic degrees.

· First Aid certificates.

· Other certificates such as CPR, BLS, etc.

· Education:

· Schools:

· 1480 primary schools

· 840 intermediate schools.

· 641 high schools

· Coalition:

· International Committee of the Red Cross (ICRC)

· The International Federation of Red Cross and Red Crescent Societies (IFRC).

· Standards:

· International and local.

· Similar agencies:

· It is the only agency that provides this service in Saudi Arabia.

· Stellar:

· International Committee of the Red Cross (ICRC)

· Agency legal:

· In house: they have to get the permission to enter any house.

· Out side: they have to get the permission from the patient if he is conscious.

· Activities:

· They hold classes to get some certificates in CPR, BLS, PHALS, and ACLS.

· They visit schools to provide first aid workshop.

· Output:

· Knowledge

· Organization

· Public relation

· Fines

· Initial outcome

· Trained population

· Safe business and increase income

· Intermediate outcomes

· Serve in emergency

· Less injury

· Long term outcome

· Safe lives

· Leads to Better service

· Less problem

· Goal: To save lives.

1. Operations:

• Air med

• Ground med:

· They are all connected to the operation room

· Assistant Director of Technical Affairs.

· Assistant Director of Administrative Affairs.

· Emergency Services.

· IT and Communication

· Transportation and Support Services

· Medical Supply

· Training and Human Resources

· Directorate General of Aviation

· Technical Affairs Department

· Field Supervisors

· Physicians

· Paramedics

· EMTs

2. Audience:

· Responders High

· Schools. High

· Businesses. Medium-High

· Faith based community. High

· Hospitals. High

· Residents’ city (the admin). High

· Visitors. Medium.

· Law Enforcement. Medium-low

· Seniors. High

· Population. High

3. Users of evaluation:

· Directors. Medium-high.

· Supervisors. Medium-high

· Managers. Medium to high

· Physician. High

· Paramedics. High

· EMTs. High

· System description

· Operation room:

· 1 Manager works 8 hours weekdays and on call.

· Managers representative: Mr. Ali Moalla Alharbi

· 1 Shift supervisor/12 hours. Medium.

· Supervisor representative: Mr. Eyad Ali

· 5 EMT Dispatchers/12 hours. High

· EMTs Dispatchers representative: Fahad Almutairy.

· 5 EMT Monitors/12 hours. High

· EMTs Monitors representative: Mr. Mazen Alotaibi

· 1 Shift Physician/12 hours. High

· Physicians representative: Dr. Alla Mohammad

· 1 Technical engineer for computers/12 hours. Law.

· 20 Stations:

· Each Station consists of:

· 1 Manager works 8 hours weekdays and on call. Medium.

· Stations Manager representative: Mr. Hatim Asshamary

· 1 Physician/12 hours shift. High

· Stations Physicians representative: Dr. Emad Fahad

· 2 Paramedics/12 hours shift. High

· Stations Paramedic representative: Mr. Faisal Alosaimi

· 4 EMTs/12 hours shift. High

· Stations EMTs representative: Mr. khaled Yaseen.

·

· We are doing this evaluation for many reasons:

· Gain Insight – we want to know if they are doing what it should be?

· Is the program feasible?

· Yes, the program we are doing is feasible and one of the important things that EMTs care about.

· Are we reaching the target audience?

· It is going to reach the target audience and it is going to be effective and helpful for the target audience when we improve the response time.

· Are we meeting objectives?

· Standard of response time is 10-15 minutes. We are 15-20 minutes.

· We need to work in this problem and make it as standard.

· Standard is 10-15 minutes, which is the response time in Jeddah, another city in Saudi Arabia.

· What is client/staff satisfaction?

· They will be both happy if we really achieve the main goal in our program.

· Change Practice – we want to know if they are doing it the right way?

· By comparing the response time in Saudi Red Crescent Authority (SRCA) in Riyadh with standard.

· Effectiveness and efficiency:

· Our goal is to evaluate the program and find the problems that slow the response time, either in the agency or other stations.

· Achieving goals and objectives?

· Current goals and objectives of the agency:

· Storage, shelter, medicines, and all what is needed to treat the sick and wounded prisoners and care.

· Provide the necessary immediate first aid to the victims of accidents, disasters and calamities public.

· Transport the sick and injured in accidents and contribute to the treatment and to participate in the fight against epidemics and provide medical services and to participate in the dissemination of culture, health, construction and management of hospitals, clinics and pharmacies, clinics and aid stations and blood transfusions.

· Provision of health services and medical assistance to the pilgrims and health care in cooperation with the competent departments.

· The advancement of the nursing profession and work to measure nurses, and trained on the work of hospitals and emergency as well as specialists, social workers and others who need them to achieve their purposes, whether they are full-time or volunteer, and this is particularly either training courses or create schools ambulance, nursing or assistance in the establishment.

· Insurance of first aid at the scene and transport the sick and injured to treatment centers.

· Contribute to the humanitarian and social services consistent message and Red Crescent Societies.

· Publication of the purposes and principles of the Red Crescent humanitarian.

· Closer relations and the exchange of aid possible between them and the Crescent Societies and the International Red Cross and other similar bodies.

· We are going to evaluate goals and objectives by evaluating the work of the stuff and see if they really meet them or not.

· We are going to ask the paramedic in charge of EMTs, and ask him many question such as:

· Do EMTs insure first aid at the scene and transport sick patients quickly?

· Do EMTs provide the necessary care immediately to patients?

· And so on with the other goals and objectives.

· What are the barriers and propellers?

· Barriers:

· Some EMTs are resistance to evaluation, which may affect on the correct information we want from them.

· Because of the previous one, we might have lack of accurate information.

· Some stations, which don’t meet standard, are in high traffic areas.

· Propellers:

· Great records:

· They took the average of 100 calls and found out that the range of the response time is between 10-20 minutes.

· Paramedic and EMTs respond as a mix team.

· Because of that, we don’t need at the moment to measure the average of the response time again, which will save us more time and probably money.

· Assess Effects:

1. To see how much time EMTs need to arrive to patients.

2. To compare the response time to similar organizations and standards.

3. To find the best solutions to make the response time shorter, which will lead to the following goal.

4. To improve the quality of service and safe lives.

· We are evaluating the response time for EMTs to reach their patients.

· So, we want to know how much time EMTs need to reach to the patient.

· We found out from the first research that EMTs need 10-20 minutes in Riyadh to reach a patient. Standard however is 10-15 minutes.

· We took this information from the operation room director by interviewing him.

· They recorded the response time of 100 calls and from that they took the average time.

· Stakeholders who want to know about the program: (from High- medium)

· Physician. High

· Paramedics. High

· EMTs. High

· Hospitals. High

· Directors. Medium

· Supervisors. Medium

· Managers. Medium

· Instrument:

· We asked operations, stakeholders, and target audience, what they want to know from this evaluation. We made a group that has all the employees’ emails we need, and we sent them the question.

· So, we will gather the information we need from their response to our email.

· Findings:

· 100 employees participated in this group email.

· The important things they want to know:

· Are we spending a lot of money we don’t need to in order to meet the standard?

· Are we meeting the standard already?

· Is it going to cost us a lot to meet that standard?

· Is it worth the cost to improve the response time?

· Is it safe for us to meet standard?

· Am I going to work longer?

· Are we going to be paid for extra work if we need to add more stations?

· What management is doing to help me meet that standard?

· Which stations meet the standard, which ones do not?

· Need Assessment

· Epidemiology:

· Problems: the responds time is not as the standard, which is 10-15 minutes in Jeddah

· The average respond time was from 15-20 minutes, which means it happens commonly.

· Out of 100 calls the average time is between 15-20 minutes.

· One of the target audiences in Riyadh is car accident.

· Last year:

· There were 775 cases considered as critical cases from car accidents.

· There were 243 deaths from car accidents.

· Agency:

· Agency needs:

· They will wait for next year to work on our program

· They get financial support from the government each year, which will help them to consider our solution when they have enough money.

· Need more employees, and more equipment.

· Agency wants:

· They want the population to notice that they are doing something for them for their cares.

· They want to show also hospitals that they use the most modern technology and equipment when transferring patients to hospitals.

· Agency Issue

· The response time is 15-20 minutes

· It is an issue because it is more than the standard.

· Target Population:

· Paramedics

· EMTs

· Resources:

· Equipment and facility: such as ambulances

· Time: their work hours

· Money: agency budget

· Barriers:

· Getting more employees.

· Getting more equipment, such as ambulances, etc.

· Deficiency in budget.

· Support:

· SRCA director and other employees in Riyadh like the program and want to fix this issue.

· Population like it, they want the agency to be more professional as soon as possible.

· Target population

· Needs:

· The new work or solution should be understandable and should be done by whole stuff.

· Program needs to be done on shifts.

· They need to be authorized.

· It should be part of their regular work, not adding extra hours on their shifts

· Wants:

· They want not to loose money if they fail doing it since it is still under process.

· They want to work in or close to the station they used to work in. for example paramedics and EMTs who work in a stations helps the east side of the city, they should still work and provide help for the east side.

· Do they see this as a priority?

· Yes, target population really wants to make the response time better.

· How do they want it?

· It must be done within the shifts that already scheduled for each EMT or Paramedic. So, in their work hours.

· It must be done in the station they work in.

· Must be convenient.

· The survey they need to take should be online.

· What are they willing to do to get it?

· They are willing to do it within their shifts and if extra time needed they want to be paid for that extra time.

· If they stay late, they want food and drink after shifts.

· What are the barriers?

· Some of target populations have other things to do after shifts, such as another work, or completing their education at night.

· What are the supports?

· The work hours in stations are 24/7, so if some of the EMTs in one shift can’t do it, we can use the other ones in the other shifts.

· What is their baseline?

· Right now the response time is 15-20 by taking the average of 100 calls in the past.

· Stakeholders

1. Operations:

• Air med

• Ground med:

· Director of Red Crescent. High

· Assistant Director of Technical Affairs. Medium

· Assistant Director of Administrative Meduim.

· Emergency Services. High

· IT and Communication. Medium

· Transportation and Support Services. High

· Medical Supply. High

· Training and Human Resources. Low

· Directorate General of Aviation. Low

· Technical Affairs Department. Low

· Field Supervisors. Low

· Physicians. High

· EMTs. High

· Paramedics. High

2. Audience:

· Community. High

· Schools. High

· Faith based community. High

· Hospitals. High

· Residents’ city (the admin). High

· Visitors. Medium.

· Law Enforcement. Medium-low

· Seniors. High

· Population. High

3. Users of evaluation:

· Directors. Medium-high.

· Supervisors. Medium-high

· Managers. Medium to high

· Physician. High

· Paramedics. High

· EMTs. High

· Their requirements, needs & wants.

· The response time is their concern, so they want to improve it.

· They need to know what are we doing.

· They need to know the results.

· They need to be involved in the program.

· They need some input.

· What resources do they bring?

· They have the data we need, which is the average response time.

· How do they want to participate?

· They can let us discuss the program with the target population who are Physicians, paramedics and EMTs.

· Findings:

· 250 employees participated in the survey.

· All participants answered all questions.

· For the first question, do you think we really need to improve the response time?

· 225 employees have chosen “ Strongly Agree.”

· 17 employees have chosen “ Agree”

· 8 employees have chosen “ Somehow Agree”

· For the Second Question, We can reduce the response time by adding more stations:

· 150 employees have chosen “ Strongly Agree”

· 45 employees have chosen “ Agree”

· 20 employees have chosen “ Somehow Agree”

· 35 employees have chosen “ Disagree”

· For the third question, we can reduce the response time by educating people on how ambulances can pass them easily.

· 130 employees have chosen “ Strongly Agree”

· 50 employees have chosen “ Agree”

· 25 employees have chosen “ somehow agree”

· 20 employees have chosen “ Disagree”

· 25 employees have chosen “ Strongly Disagree”

· For the forth question, we need more employee such as EMTs, paramedics, in order to reduce the response time:

· 235 employees have chosen “ Strongly Agree”

· 7 employees have chosen “ Agree”

· 8 employees have chosen “ Somehow Agree”

· For the fifth question, we need more equipment, such as ambulances, to reduce the response time by spreading them around the city.

· 220 employees have chosen “Strongly Agree”

· 16 employees have chosen “ Agree”

· 10 employees have chosen “ Somehow Agree”

· 4 employees have chosen “ Disagree”

· For the last question, For every call, we need to send paramedics and physicians using small cars first:

· 180 employees have chosen “ Strongly Agree”

· 35 employees have chosen “ Agree”

· 25 employees have chosen “ Somehow Agree”

· 10 employees have chosen “ Agree”