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1AmbulAnce Service of new South wAleS: AeromedicAl SAfety And riSk mAnAgement enhAncement StrAtegy

AmbulAnce Service new South wAleS AeromedicAl SAfety And riSk mAnAgementenhAncement StrAteGY

AmbulAnce Service of new South wAleS: AeromedicAl SAfety And riSk mAnAgement enhAncement StrAtegy 03

AmbulAnce Service of new South wAleS AeromedicAl SAfety And riSk mAnAgement EnhancEmEnt StratEgy DeveloPeD bY: Aerosafe risk management� PrePAreD for: Ambulance Service of new Sout�h WalesDAte of DeveloPment: december 2012

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About AeroSAfe riSk mAnAGement

Aerosafe risk management� has been chosen t�o design and implement� t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy. Aerosafe is a result�s-driven professional organisat�ion wit�h a high level of management� and t�echnical expert�ise. Aerosafe’s experience and proven result�s in t�he aviat�ion indust�ry suggest�s a simple but� det�ailed met�hodology and philosophy t�hat� one must� ‘creat�e an environment�’ t�hat� will ‘influence t�he behaviours’ t�hat� will ‘shape a cult�ure’. this is evidenced by t�heir work in t�he field of aviat�ion risk management� implement�at�ion for t�he past� fift�een years and t�he support� of a client� base of 300 companies in 16 count�ries. Aerosafe posses t�he necessary skills, experience and met�hodology required t�o implement� an aviat�ion oversight� arrangement� and have been t�he preferred supplier of services t�o t�he civil Aviat�ion Safet�y Aut�horit�y for a number of years. Aerosafe has ext�ensive experience bot�h nat�ionally and int�ernat�ionally in t�he Air Ambulance sect�or and has a proven and unique t�rack record in delivering out�comes in t�his domain. in addit�ion, for t�he past� t�wo years, Aerosafe has been t�he lead aviat�ion consult�ancy firm advising a royal commission in canada on t�he management� of aviat�ion cont�ract�s and operat�ors for t�he offshore oil indust�ry.

© coPYriGht AeroSAfe riSk mAnAGement 2012

this document� has been developed by Aerosafe risk management� in response t�o work commissioned by t�he Ambulance Service of new Sout�h Wales. the int�ellect�ual propert�y inherent� in t�he met�hodologies, models, copyright�, pat�ent� and t�rade secret�s used t�o produce t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy remains t�he propert�y of Aerosafe risk management�.

DiSclAimer

While t�he aut�hors and publisher have t�aken reasonable precaut�ions and made reasonable effort�s t�o ensure t�he accuracy of mat�erial cont�ained in t�his report�, Aerosafe risk management� does not� guarant�ee t�hat� t�his publicat�ion is wit�hout� flaw. the aut�hors and publisher make no warrant�ies, express or implied, wit�h respect� t�o any of t�he mat�erial cont�ained herein and t�herefore disclaim all liabilit�y and responsibilit�y for errors, loss, damage or ot�her consequences t�hat� may arise from relying on informat�ion in t�his publicat�ion.

DeveloPeD bY AeroSAfe riSk mAnAGement Suit�e 5, level 1, 40 lord St�reet� Bot�any, nSW 2019 Phone +61 2 8336 3700 www.aerosafe.com.au


tAble of contentSa mESSagE From thE chiEF ExEcutivE 06

a mESSagE From thE DirEctor StatEwiDE SErvicES 09

BackgrounD 10

EnhancEmEnt StratEgy 11

thE 5 Point Plan 13

Point� 1 – St�rat�egy and implement�at�ion Planning 14

Point� 2 – governance/risk framework 16

Point� 3 – St�rat�egic risk Profile 18

Point� 4 – operat�ional risk management� 20

Point� 5 – int�roduct�ion of new and enhanced pract�ices 22

imPlEmEntation PhaSES 24

ovErSight anD accountaBility 25

concluSion 26

contactS 27

AmbulAnce Service of new South wAleS: AeromedicAl SAfety And riSk mAnAgement enhAncement StrAtegy06

in my role i am ult�imat�ely responsible t�o t�he St�at�e government� and t�he people of nSW for corporat�e, clinical and public sect�or governance wit�hin t�he Ambulance Service of new Sout�h Wales (Ambulance). this commit�ment� nat�urally cut�s across t�he element� of Safet�y and risk management�. in fact�, reference t�o t�he corporat�e governance At�t�est�at�ion St�at�ement�, which i signed on August� 31st� t�his year, shows t�hat� i am ult�imat�ely responsible t�o ensure t�hat� Ambulance has est�ablished “sound audit� and risk management� pract�ices”.

All of t�he governance funct�ions delivered t�hrough t�he execut�ive management� Board are driven by t�hree principle commit�t�ees – Audit� and risk, finance, and clinical governance. As a result� Ambulance has est�ablished st�rong int�ernal audit� and risk management� processes, which provide a level of assurance t�hat� enables me, and t�he senior management� of Ambulance, t�o recognise, underst�and, manage and effect�ively cont�rol our exposure t�o risk. however risk is dynamic by nat�ure and requires const�ant� vigilance t�o ensure our safet�y defences prot�ect� all of our st�akeholders.

Such vigilance requires our const�ant� at�t�ent�ion t�o ensure our high st�andards of performance are met�. one of t�he best� ways t�o maint�ain such a focus is t�o cont�inually review our processes and pract�ice t�o look for cont�inuous improvement�. this is t�he premise behind t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy, part�icularly given t�he hazard rich environment� of our aviat�ion act�ivit�ies.

Wit�hin Ambulance we employ over 4,000 people, wit�h 90 per cent� of t�hose being operat�ional st�aff involved in t�he front� line delivery of services. All of our people are commit�t�ed t�o providing high qualit�y clinical care and healt�h relat�ed t�ransport� services t�o over 7.25 million people in nSW, dist�ribut�ed across an area of 801,600 square kilomet�res. this includes paramedics, pat�ient� t�ransport� officers and specialised areas such as int�ensive care and ext�ended care paramedics, special operat�ions, count�er disast�er, and of course our aeromedical and medical ret�rieval t�eams. We owe all of t�hese people a workplace wit�hin which risk is reduced t�o as low as reasonably pract�icable.

the average number of responses across Ambulance is increasing each year, and by 1.5 per cent� over t�he past� year alone, t�o over 1,183,795 t�ot�al responses (bot�h emergency and non-emergency). We also owe t�his growing number of client�s not� just� high qualit�y clinical care, but� also a safe service where risks are ident�ified and cont�rolled. there were on average 3,234 responses per day last� year, which is equivalent� t�o a response every 26.7 seconds. the aeromedical operat�ion dealt� wit�h 3665 fixed Wing, 3481 helicopt�er, and 1693 road of t�hose responses, which represent�s around 24 daily missons by what� is a comparat�ively small t�eam, but� a t�eam faced wit�h unique hazards and risks.

the st�rat�egy out�lined on t�he following pages support�s t�he four pillars of our organisat�ional values - Professional st�andards of behaviour, Promot�e and encourage t�eamwork, Show care and respect�, and Act� responsibly and be account�able. enhancing our safet�y and risk process and pract�ice not� only makes good sense, but� is indicat�ive of t�he commit�ment� t�he governance t�eam has made t�o ensuring our organisat�ion cont�inually improves our pract�ices.

A meSSAGe from the chief eXecutivemr. mikE williS – acting

“AS the Acting chief executive of the AmBulAnce Service of nSW i’m keenly focuSed on, And fully SuPPortive, of the AeromedicAl SAfety And riSk mAnAgement enhAncement StrAtegy outlined in thiS Booklet.”


this service is ready 24 hours a day t�o respond t�o calls following pre-hospit�al t�rauma, as well as int�er-hospit�al crit�ical care ret�rievals on a variet�y of plat�forms including helicopt�ers, road vehicles and fixed wing aircraft�. this complex t�ransport� net�work means t�hat� t�he command and cont�rol element�s alone become crit�ical and present� risk t�hat� must� be well managed. When t�he complexit�y of skills and operat�ing environment�s is included, t�he focus on robust� risk management� assumes great� import�ance.

our helicopt�er medical t�eams consist� of an experienced crit�ical care physician, int�ensive care paramedic (icP) – including Special casualt�y Access team (ScAt) paramedics – pilot� and hemS crewman. our doct�ors are specialist�s in emergency and int�ensive care medicine and anaest�het�ics, or are senior t�rainees in t�hose specialt�ies wit�h a specific focus and enhanced t�raining in pre-hospit�al and ret�rieval medicine. our paramedic st�aff are experienced icPs, many wit�h ScAt t�raining, enabling t�hem t�o access and t�reat� pat�ient�s in a wide range of challenging environment�s, from mount�ain canyons t�o ocean rescue.

this synergist�ic skill-set� gives us t�he abilit�y t�o manage any mission we respond t�o – from a remot�e bush-land winch ext�ract�ion t�o sophist�icat�ed crit�ical care icu t�ransfers. our road-based medical t�eams consist� of an experienced crit�ical care physician and icP. our fixed wing t�eams include crit�ical care physicians and experienced flight� nurses, who are based at� Air Ambulance at� Sydney Airport� and dubbo Airport�.

on pre-hospit�al missions, our aim is t�o bring t�he emergency depart�ment� (ed) t�o t�he pat�ient� as soon as possible following t�rauma. on int�er-hospit�al missions, our aim is t�o t�ake t�he int�ensive care unit� (icu) t�o t�he pat�ient� wherever t�hey are in nSW. the vast� majorit�y of t�his highly skilled work by dedicat�ed personnel is undert�aken wit�hin t�he aviat�ion environment�. this means t�he risks associat�ed wit�h t�he provision of crit�ical care are amplified by t�he risks of t�he aviat�ion operat�ing environment�. change is cont�inuous wit�hin clinical operat�ions and our aviat�ion services need t�o keep pace wit�h t�his change. this adds addit�ional risk which requires common aviat�ion risk management� t�ools across all of our operat�ions t�o ensure t�he desired safet�y out�comes.

the best� out�comes are achieved t�hrough st�rong clinical governance and safet�y and risk management�. A safet�y syst�em t�hat� incorporat�es robust� safet�y oversight� and uses formal risk management� as it�s primary t�ool is t�he key. this t�akes a high level of commit�ment� and t�he need t�o engage and work t�oget�her by all st�akeholders. the benefit�s of a focus on t�he safet�y and prot�ect�ion of people and asset�s includes t�he achievement� of great�er pat�ient� care. i have commissioned t�he project� t�o deliver t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy out�lined in t�his booklet� because i’m convinced it� is t�he ideal met�hod t�o provide us wit�h just� t�he t�ools we need t�o review and ult�imat�ely enhance our current� safet�y and risk syst�ems where necessary.

A meSSAGe from the Director StAtewiDe ServiceSDr. ron manning

“AS the director of StAteWide ServiceS i overSee An AeromedicAl And retrievAl Service thAt cArrieS out juSt under 9,000 miSSionS every yeAr treAting Some of the StAte’S SickeSt PAtientS.”

10 AmbulAnce Service of new South wAleS: AeromedicAl SAfety And riSk mAnAgement enhAncement StrAtegy

from humble beginnings wit�h personnel running hand lit�t�ers, t�hrough t�he int�roduct�ion of horse drawn unit�s, and t�hen ont�o mot�or vehicles, Ambulance now has a fleet� of some 954 ambulances, a fleet� of fixed and rot�ary wing aircraft�, and over 400 support� vehicles which includes rescue t�rucks, megalift� ambulances, and 36 rapid response and administ�rat�ive vehicles.

the aviat�ion services of Ambulance began wit�h t�he Air Ambulance sect�ion, which was est�ablished in march of 1967 ut�ilising a single Beechcraft� Queen Air aircraft�. oct�ober 1985 saw an upgrade t�o t�he Beechcraft� king Air 200c, giving client�s and st�aff great�er speed, comfort� and capabilit�y.

rot�ary wing operat�ions began in 1973 wit�h a single iconic Bell 47 operat�ing only on weekends during t�he summer wit�h volunt�eer crew. doct�ors were added t�o t�he crew list� in 1975 and by 1978 t�he first� st�at�e government� cont�ract�ed helicopt�er service had begun. Paramedics joined t�he crew in 1981 and Special casualt�y Access team (ScAt) paramedics in 1986, in a rescue crewman role.

the aviat�ion sect�ion, now known as t�he Aeromedical division, current�ly has a fleet� of 7 king Air fixed wing aircraft�, which are under cont�ract� from t�he royal flying doct�or Service, and 12 helicopt�ers under cont�ract� wit�h various operat�ors across t�he St�at�e. the Aeromedical division sit�s wit�hin t�he St�at�ewide Services sect�ion of Ambulance and is headed by dr. ron manning. this division includes t�he Aero medical ret�rieval unit� (Amru) and t�he Aeromedical operat�ions cent�re (Aoc). the healt�h emergency management� unit� also falls wit�hin t�his division.

the workload for t�he Aeromedical division varies each year, but� for 2011/12 it� included 3,665 fixed Wing, 3,481 helicopt�er and 1,693 road responses. the aeromedical t�eam brings t�o pat�ient� care t�he skills and experience of a specialist� physician, advanced airway and pain relief, advanced diagnost�ic t�ools, blood product�s and t�he abilit�y t�o get� t�o t�he right� hospit�al in t�he right� t�imeframes. given t�he complexit�ies of t�he aviat�ion and clinical environment�s, all of t�hese benefit�s bring opport�unit�y as well as risk. robust� risk management� is t�he enabler of opport�unit�y while ensuring hazards are cont�rolled.

bAckGrounDthe AmBulAnce Service of nSW WAS firSt eStABliShed in 1895 And over the 117 yeArS of oPerAtionS it hAS groWn to Become one of the lArgeSt of itS kind in the World.


the SAfetY AnD riSk mAnAGement enhAncement StrAteGYthere iS AmPle evidence from PuBliShed documentAtion, And demonStrAted PrActice, thAt AmBulAnce iS committed to oPerAting in A SAfe And efficient mAnner. this commit�ment� is exemplified by t�he Aeromedical division, which is det�ermined t�o ensure it�s process and pract�ice is cont�inually reviewed t�o ensure operat�ions are consist�ent� wit�h best� pract�ice. this is t�he foundat�ion of t�he commit�ment� t�o an enhancement� of safet�y and risk management� pract�ices and t�he genesis t�o t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy cont�ained wit�hin t�his booklet�.

Ambulance int�ernal governance st�at�ement�s, published organisat�ional values, and code of conduct�, clearly show t�hat� Ambulance is det�ermined t�o be and remain a t�rust�ed, resilient� and reliable organisat�ion. resilience comes from t�he formal management� of organisat�ional risk. Whet�her it� be corporat�e risk, risk associat�ed wit�h change and growt�h, or operat�ional safet�y risk, t�he planned and proact�ive management� of hazards t�hat� expose t�he organisat�ion t�o risk provides t�he management� syst�ems of Ambulance wit�h t�he abilit�y t�o adjust� it�s process and pract�ices t�o deal wit�h bot�h expect�ed and unexpect�ed condit�ions, eit�her posit�ive or negat�ive.

reliabilit�y comes from t�he abilit�y t�o cope wit�h unant�icipat�ed organisat�ional performance when t�he unexpect�ed arises. the key t�o reliabilit�y, and ult�imat�ely becoming a highly reliable organisat�ion (hro), is for bot�h t�he organisat�ion and it�s people t�o be prepared for variable performance, and t�he unexpect�ed, t�hrough a chronic unease t�hat� hazards can be unlocked and become a risk t�o organisat�ional object�ives wit�hin even t�he best� designed and defended syst�ems.

Bot�h resilience and reliabilit�y are t�herefore root�ed in a process of on-going review of process and pract�ice. this provides t�he opport�unit�y for cont�inuous improvement� t�hrough lessons learned and predict�ive planning. it� is just� t�his on-going review of process and pract�ice t�hat� has recognised an opport�unit�y t�o enhance Ambulance’s safet�y and risk management� syst�em t�o ensure cont�emporary pract�ice and t�he lat�est� in process design.

the result�ant� Aeromedical Safet�y and risk management� enhancement� St�rat�egy has been developed int�o a 5 point� plan covering t�he period 2012 - 2015. the broad st�rat�egic object�ives are t�o obt�ain an appropriat�e corporat�e response t�o enhancing t�he aviat�ion governance arrangement�s, undert�ake operat�ional assurance act�ivit�ies, creat�e a formal risk management� framework, and commit� t�o enhancement� act�ivit�ies once t�he current� mat�urit�y level of pract�ice is measured. the 5 point�s and purpose of t�he St�rat�egy is t�o provide Ambulance wit�h t�he following:

01. a planned approach to growth and change

02. Enhanced governance and safety oversight arrangements

03. a risk-based approach to the delivery of aeromedical services to the State

04. consistency and visibility of aviation and clinical operational practice

05. an improved safety culture and risk practice

det�ail of each of t�he 5 point�s of t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy can be found on t�he following pages, where t�he purpose, object�ive, t�asking, expect�ed out�comes and measures of success are out�lined.


the 5 Point PlAn

Point 1 Point 2 Point 3 Point 4 Point 5StratEgy anD imPlEmEntation Planning

govErnancE/ riSk FramEwork

StratEgic riSk ProFilE

oPErational riSk managEmEnt

introDuction oF nEw anD EnhancED PracticES

ADoPt A PlAnneD APProAch to Growth AnD chAnGe.

this point� is designed t�o provide an organisat�ional definit�ion, and t�o const�ruct� t�he enhancement� act�ivit�ies, by out�lining t�he overall st�rat�egy. the st�rat�egy considers t�he int�erface bet�ween Ambulance, it�s aviat�ion cont�ract�ors, and all t�he associat�ed syst�ems and processes. the out�come of t�his point� provides a foundat�ion for t�he coming mont�hs of act�ivit�y while providing Senior execut�ives wit�hin Ambulance wit�h a clear and direct� st�rat�egy t�hat� can be t�racked and measured.

DeveloP AnD imPlement enhAnceD GovernAnce AnD SAfetY overSiGht ArrAnGementS.

for t�his point�, t�he focus of t�he st�rat�egy t�urns t�o addressing t�he general governance and risk management� aspect�s, including t�he development� of a risk management� framework gap analysis. this body of work will provide t�he st�ruct�ure by which Ambulance can move forward. the result�s from t�he gap analysis and t�he risk profile act�ivit�y in point� 3 will be inst�rument�al in informing risk reduct�ion act�ivit�ies and developing recommendat�ions for t�he enhancement� act�ivit�ies going forward.

eStAbliSh A viSible riSk-bASeD APProAch to the DeliverY of AeromeDicAl ServiceS to the StAte.

this point� sees t�he development� of a risk profile t�o gain an independent�, accurat�e and valuable assessment� of t�he current� risks, issues and pressures in t�he organisat�ion across t�he cont�ext� of t�he associat�ed cont�ract�s, operat�ors and operat�ions. following t�he ident�ificat�ion of risk, and in consult�at�ion wit�h t�he nominat�ed st�akeholders, a set� of risk t�reat�ment� st�rat�egies t�hat� will proact�ively drive risk reduct�ion effort�s in t�he coming mont�hs are ident�ified and present�ed.

Achieve conSiStencY AnD viSibilitY of AviAtion AnD clinicAl oPerAtionAl PrActice AcroSS the StAte network of oPerAtorS.

this point� develops a set� of risk profiles for t�he operat�ional act�ivit�ies (t�asks) undert�aken by t�he operat�ors across t�he net�work. the aim of t�his act�ivit�y is t�o re-est�ablish, using a risk based approach, t�he definit�ion, scope, limit�at�ions and risks associat�ed wit�h t�he various t�ask profiles required t�o be undert�aken by t�he operat�ors.

An imProveD SAfetY culture AnD riSk PrActice.

once t�hefirst� 4 point�s have been complet�ed a formal pause and check point� in t�he st�rat�egy t�akes place t�o examine t�he current� sit�uat�ion, t�he st�at�e of mat�urit�y of pract�ice, t�he level of assurance required and t�he int�ended out�come of any furt�her enhancement�.


PurPoSe:

the purpose of adopt�ing a st�ruct�ured approach t�o st�rat�egy development� and implement�at�ion planning for safet�y and risk management� is t�o provide Ambulance wit�h an overall planned approach t�o growt�h and change. Wit�h any growt�h or change comes risk. the only effect�ive way t�o manage t�his risk is t�hrough robust� planning t�hat� ut�ilises risk management� as a project� t�ool.

objective:

the ultimate objectives of this point include:

01. clear direct�ion of required change

02. communicat�ion of t�he scope of change

03. A consist�ent� plat�form for underst�anding by all st�akeholders

04. Plan for and resource t�he act�ivit�ies required t�o facilit�at�e change

05. measure achievement�

eXPecteD outcomeS:

the primary out�come of t�his st�age is t�he development� of t�he overall st�rat�egy for t�he enhancement� of safet�y and risk management� wit�hin t�he Aeromedical division of Ambulance, and also t�he development� of an implement�at�ion plan t�hat� will be used as t�he blue print� for all of t�he act�ivit�ies creat�ed by each of t�he 5 point�s of t�he plan t�hat� support� t�he st�rat�egy.

Point 1: StrAteGY AnD imPlementAtion PlAnninGAmbulance has already dedicat�ed a large amount� of effort� int�o commissioning invest�igat�ions, evaluat�ions and reviews of exist�ing pract�ices, bot�h int�ernal and ext�ernal. it� is now very import�ant� t�hat� a common view of t�he approach t�hat� is being adopt�ed, t�he underpinning object�ives of t�he change program, t�he expect�ed out�comes, and t�he act�ivit�ies t�o achieve t�hose out�comes are clearly art�iculat�ed. this higher level piece of work frames up t�he cont�ext� of ot�her act�ivit�ies and is crit�ical in providing all t�he st�akeholders wit�h vision int�o Ambulance st�rat�egy and t�he plan for implement�ing any change.


Point 1: StrAteGY AnD imPlementAtion PlAnninG

taSkS mEaSurES oF SuccESS

the tasks required to complete this activity include the following:

• develop t�he framework for t�he enhancement� st�rat�egy

• engage wit�h t�he chief execut�ive and senior leadership

• conduct� a full st�akeholder analysis t�o det�ermine all groups and individuals requiring communicat�ion or engagement�

• Promulgat�e t�he enhancement� plan

• Publish t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy

• Publish t�he implement�at�ion Plan for t�he st�rat�egies and recommendat�ions creat�ed t�hroughout� t�he project�

• monit�or progress at� Ambulance execut�ive level

• monit�or progress at� operat�or chief execut�ive level.

measuring t�he success of any process of change and growt�h is vit�al. Such measures are not� only a requirement� of good governance, but� t�hey also enable a post� implement�at�ion review t�o det�ermine value and also ident�ify any condit�ions which may give rise t�o pot�ent�ial lat�ent� failure and increased risk exposure.

measures of the success of this strategic stage of work include:

• uncondit�ional buy-in from relevant� st�akeholders

• A commit�ment� from all st�akeholders t�o t�he st�rat�egy and it�s enhancement� act�ivit�ies

• full implement�at�ion of st�rat�egies cont�ained wit�hin t�he implement�at�ion plan

• more robust� governance t�hrough deep underst�anding of assurance requirement�s

• A st�rengt�hening of organisat�ional cult�ure based on published company values

• A mat�uring of t�he organisat�ions safet�y cult�ure.

given t�he broad nat�ure of t�hese act�ivit�ies and t�heir linkage t�o out�comes of each of t�he ot�her point�s, t�hese measures will only be able t�o be assessed over a t�imeframe consist�ent� wit�h t�he life-cycle of t�he wider st�rat�egy and it�s overall implement�at�ion.


PurPoSe:

the overall purpose of enhancing governance, and t�he associat�ed safet�y and risk oversight� arrangement�s, is t�o provide formal risk management� at� t�he operat�ional level and consist�ent� levels of assurance for all st�akeholders. By examining, measuring and ult�imat�ely st�rengt�hening t�he element�s of Assurance and risk management� it� is possible t�o provide an equally st�rong process of safet�y oversight�.

objective:

the object�ive of t�his body of work is t�o enhance exist�ing governance arrangement�s at� Ambulance by providing an Aviat�ion Assurance Program consist�ing of an Applicat�ion map and an Assurance plan. combined wit�h t�he development� of a risk management� framework gap Analysis, t�his st�age of t�he st�rat�egy will provide t�he st�ruct�ure by which Ambulance can move forward in confident�ly guiding and direct�ing risk reduct�ion act�ivit�ies wit�hin t�he Aeromedical division.

eXPecteD outcomeS:

the primary out�come expect�ed of t�his act�ivit�y is t�he development� and implement�at�ion of an aviat�ion assurance program t�hat� provides a st�ruct�ure of ‘checking act�ivit�ies’ required t�o give t�he level of confidence needed t�o ensure all oversight� and operat�ional act�ivit�ies are being undert�aken t�o t�he pre-det�ermined and defined requirement�s. it� will include a plan t�hat� det�ails t�he organisat�ional applicat�ions, what� needs t�o be checked, t�o what� level of dept�h (assurance level 1, 2 or 3), a pre-agreed appropriat�e mechanism for gaining assurance, and t�he frequency of assurance.

As part� of t�he assurance program an applicat�ion map t�hat� provides t�he definit�ion and scope of applicat�ions across t�he organisat�ion, provided by a ‘pict�orial represent�at�ion’ of t�he high level funct�ions across t�he organisat�ion t�hat� requires oversight�, will be developed. this applicat�ion map is a key element� of a risk management� framework, so an addit�ional out�come of t�his st�age will be t�he development� of a gap analysis t�o det�ermine what� risk management� st�ruct�ure and pract�ices are already in place and provide a clear implement�at�ion plan for enhancement� of t�he current� syst�em.

Point 2: GovernAnce/riSk frAmeworkgovernance is t�he key responsibilit�y of t�hose wit�hin Ambulance who are ult�imat�ely account�able t�o t�he government� and cit�izens of t�he St�at�e. robust� governance relies on t�he exist�ence and implement�at�ion of t�he t�hree pillars of compliance, Assurance and risk management�. the element� of compliance is generally well underst�ood by business, regardless of t�he indust�ry sect�or. Prescript�ive regulat�ions and legislat�ion normally ensure t�hat� compliance is a primary focus of t�he organisat�ion; save t�he ult�imat�e removal from t�he indust�ry should compliance not� be upheld. Assurance and risk management�, on t�he ot�her hand, hold variable levels of underst�anding and pract�ice across corporat�e Aust�ralia, result�ing in equally variable st�ages of st�rengt�h in governance.


Point 2: GovernAnce/riSk frAmework


the tasks required to complete this stage of work include the following:

• review t�he exist�ing risk management� framework via a formal gap analysis

• develop a formal assurance program as a key component� of t�he oversight� arrangement�s

• review all relevant� governance and risk document�at�ion, bot�h int�ernally and ext�ernally

• gain individual input� from relevant� st�akeholders t�hrough int�erviews and workshops

• develop and communicat�e a governance and oversight� st�ruct�ure via an Ambulance Aeromedical applicat�ion map

• Publish t�he Aeromedical Assurance Program and risk management� framework gap Analysis.

measuring t�he success of t�his point� of t�he st�rat�egy provides t�he confidence t�hat� any changes t�o governance arrangement�s are fit� for purpose and compliant� wit�h policies.

measures of the success of this strategic stage of work include:

• Appropriat�e met�rics of high fidelit�y are provided t�o key decision makers

• resource allocat�ion is more effect�ive

• risks are bet�t�er underst�ood for defensible decisions by account�able managers

• increased account�abilit�y t�hrough fully document�ed process and pract�ice

• compat�ibilit�y wit�h int�ernat�ional risk process and pract�ice st�andards

• direct�ion and guidance from senior management� t�hat� is bet�t�er informed and relevant�

• decision making and governance act�ivit�ies are more t�ransparent�.

given t�he high level focus of t�his st�age of work t�hese measures will only be able t�o be assessed over a t�imeframe consist�ent� wit�h t�he business report�ing and audit� cycles.


PurPoSe:

the purpose of developing a st�rat�egic risk profile is t�o adopt� a dat�a driven approach t�hat� is free of agendas and bias and delivers posit�ive out�comes. the purpose is t�o also ensure t�hat� clear and t�ransparent� account�abilit�ies are assigned. in addit�ion t�his process facilit�at�es t�he alignment� of t�he risk appet�it�e of various key st�akeholders.

objective:

the ult�imat�e object�ive of developing, communicat�ing and ut�ilising a st�rat�egic risk profile is t�o ident�ify, priorit�ise and address syst�emic risks wit�hin t�he Aeromedical division. this ext�ernal st�ock t�ake of risks will aid in t�he validat�ion of past� risk assessment�s, if undert�aken, while ident�ifying any gaps or overlaps in t�he risks already known. following t�he ident�ificat�ion of risk and in consult�at�ion wit�h t�he nominat�ed st�akeholders, a set� of risk t�reat�ment� st�rat�egies t�hat� will proact�ively drive risk reduct�ion effort�s in t�he coming 12-36 mont�hs are ident�ified and present�ed.

eXPecteD outcomeS:

the strategic risk profile will assist in adopting a risk based approach to delivering the Aeromedical transportation service and will provide the following outcomes:

• the adopt�ion of a risk based approach t�o examining t�he syst�emat�ic risks and issues of delivering t�he service using t�he accept�ed int�ernat�ional St�andards.

• ut�ilisat�ion of a joint� process t�o undert�ake a holist�ic and complet�e view of t�he issues, including t�hose wit�h int�errelat�ionships bet�ween t�he organisat�ion and operat�ors.

• Provide assurance and confidence t�o t�he key st�akeholders involved in delivering Aeromedical t�ransport�at�ion t�hat� t�he risks are known and are act�ively being managed and t�racked by t�hose account�able and responsible.

• Posit�ion t�he St�at�e government�, Ambulance and t�he operat�ors t�o collect�ively implement� a sust�ainable approach t�o support� t�he ongoing and fut�ure service delivery.

• Provide a proact�ive t�ool t�hat� will t�rigger alignment� of account�abilit�y, responsibilit�y, resourcing and accept�ance of risk.

• use of process t�hat� does not� wait� unt�il an accident� happens t�o ident�ify and address syst�emic issues t�hat� may exist� in t�he current� cont�ract� oversight�, governance and st�ruct�ure.

Point 3: StrAteGic riSk ProfileA risk profile of t�he act�ivit�ies of t�he Aeromedical division of Ambulance present�s an overarching represent�at�ion of t�he st�rat�egic risks present� wit�hin t�he division, and t�he means by which t�reat�ment� and oversight� can be conduct�ed. it� is a descript�ion of t�he set� of risks wit�hin a defined scope. this enables t�he source, cause and consequences of a risk t�o be document�ed, and for each risk t�o be analysed and evaluat�ed. the development� of t�he risk profile has it�s basis in t�he risk management� process defined wit�hin iSo 31000:2009, which generat�es a syst�emat�ic and t�ransparent� risk profile, based on indust�ry best� pract�ice met�hodology.


Point 3: StrAteGic riSk Profile


the tasks required to complete this stage of work include the following:

• conduct� a st�akeholder analysis wit�hin t�he scope of st�rat�egic risk

• undert�ake a comprehensive environment�al scan

• review any current� Aeromedical division risk regist�ers

• facilit�at�e a dedicat�ed risk ident�ificat�ion and risk t�reat�ment� workshop wit�h st�rat�egic personnel

• Promulgat�e t�he Aeromedical St�rat�egic risk Profile

• Publish t�he Aeromedical St�rat�egic risk Profile.

measuring t�he success of t�his st�age of t�he st�rat�egy provides evidence of adopt�ing a risk based approach t�o delivering t�he Aeromedical t�ransport�at�ion service and t�est�s it�s effect�iveness.

measures of the success of this activity include:

• A significant� broadening of st�akeholder consult�at�ion in all risk planning

• measurable improvement� in st�akeholder confidence t�hat� all risks facing t�he Service are ident�ified

• how well t�he risk profile is underst�ood by st�akeholders

• target�ed risk reduct�ion st�rat�egies are implement�ed effect�ively

• Syst�emic issues in cont�ract�or oversight�, governance and st�ruct�ure are addressed earlier t�han past� pract�ice.

the st�rat�egic focus of t�his st�age of work will require a focused int�ernal evaluat�ion process t�o det�ermine t�he efficacy of t�he out�comes.


PurPoSe:

given each aircraft� has a composit�e crew of bot�h st�aff from t�he operat�or and Ambulance, and in some cases nSW healt�h (or medical provider), t�he requirement� t�o have a common underst�anding of t�he risks t�o each operat�ional t�ask profile is import�ant�. this forms t�he primary purpose of creat�ing operat�ional risk Profiles (orP) as t�he out�put� of t�he operat�ional risk management� process.

objective:

the object�ive of t�his st�age of t�he st�rat�egy is t�o provide t�he confidence t�o Ambulance t�hat� any gaps in operat�ional pract�ice can and will be ident�ified and closed, result�ing in t�he achievement� of consist�ency of pract�ice across t�he net�work. the out�comes of t�he operat�ional risk management� process, known as t�he orP’s, will map a clear pat�h as t�o how t�he organisat�ion will achieve what� is needed and provide t�he “demonst�rat�ed proof” t�hat� risks are being appropriat�ely managed.

eXPecteD outcomeS:

the result�s from t�his st�age drive t�he focus of t�he operat�ional safet�y relat�ed aspect�s of t�he project�, t�arget�ing specific risk mit�igat�ion and enhancement� in safet�y and operat�ional pract�ices. in addit�ion, fact�ors t�hat� could induce safet�y risk will be ident�ified and clearly art�iculat�ed in t�he operat�ional risk profiling out�put�s.

Point 4: oPerAtionAl riSk mAnAGementjust� as wit�h point� 3, t�his st�age of t�he st�rat�egy focuses on risk, but� in t�his case t�he scope is based upon operat�ional risk rat�her t�han st�rat�egic risk. during t�he formal scoping act�ivit�y of t�he overall project� it� was ident�ified t�hat� t�he immediat�e and high priorit�y of need was t�o develop a set� of risk profiles for t�he operat�ional act�ivit�ies (t�asks) undert�aken by cont�ract�ed operat�ors across t�he Ambulance aeromedical net�work. An operat�ional risk profile, just� like a st�rat�egic risk profile, evaluat�es t�he act�ivit�ies of an organisat�ion and present�s an overarching profile of risks present� wit�hin t�he organisat�ion, but� t�he scope simply changes t�o consider operat�ional risk.


Point 4: oPerAtionAl riSk mAnAGement


the tasks required to complete this body of work include the following:

• Adopt� a st�andard met�hodology for managing operat�ional risk across t�he net�work

• develop a suit�e of operat�ional t�ask profiles for use across t�he St�at�e

• conduct� an operat�ional audit� of pract�ices against� t�he agreed set� of operat�ional t�ask profiles

• Align and improve operat�ional pract�ices t�o effect�ively manage risk

• Publish Aeromedical operat�ional risk Profiles

• Publish t�he orP gap Analysis report� and implement�at�ion plan.

measuring t�he success of t�his act�ivit�y is vit�al in assuring consist�ency of pract�ice in all operat�ions.

measures of the success of this activity include:

• the level of input� and buy-in by operat�ors achieved during t�he orP workshops

• the development� of orP’s across all t�asks undert�aken by operat�ional personnel

• the dist�ribut�ion of complet�ed orP’s across all operat�ors

• the implement�at�ion of t�he orP’s int�o each operat�or’s process and pract�ice

• evidence of regular review of t�he orP’s following implement�at�ion

• A reduct�ion in incident� and/or accident� rat�es.

the above measures will require bot�h self-evaluat�ion of successful implement�at�ion by operat�ors and a formal ext�ernal audit� of conformance.


PurPoSe:

the purpose of t�his element� of work is t�o provide a formal pause and check point� in t�he project� t�o examine t�he current� sit�uat�ion, t�he st�at�e of mat�urit�y of pract�ice, t�he level of assurance required and t�he int�ended out�come of any required enhancement�. the enhancement� implement�at�ion plan complet�ed as part� of t�he act�ivit�ies in point� 1 will be project� planned and rolled out� across t�he Aeromedical division.

objective:

the object�ive of t�his st�age is t�o implement� t�he enhancement�s ident�ified during each st�age of t�he project� across t�he ent�ire Aeromedical division wit�h t�he least� disrupt�ion t�o business as usual act�ivit�ies. cont�emporary change management� process is t�o be used t�o achieve t�he secondary object�ive of int�egrat�ing t�he enhancement�s int�o exist�ing syst�ems wit�h t�he aim of ensuring st�aff members reference safet�y and risk management� syst�em process and pract�ice in t�he course of using t�he Aeromedical division’s normal management� syst�ems.

eXPecteD outcomeS:

the primary out�come of t�his final st�age of t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy is expect�ed t�o include bot�h t�he implement�at�ion and int�egrat�ion of enhanced process and pract�ice across a range of syst�ems and will incorporat�e act�ivit�ies t�hat� will ult�imat�ely be guided by t�he implement�at�ion plan developed in point� 1, but� are expect�ed t�o include:

• Safet�y management� Syst�em enhancement�

• int�egrat�ion of incident� report�ing syst�ems and report�ing pract�ice

• training of st�aff in operat�ional risk management�

• risk management� framework implement�at�ion act�ivit�ies

• int�erface of processes and syst�ems.

Point 5: introDuction of new AnD enhAnceD PrActiceSthis is effect�ively t�he point� t�hat� deals wit�h t�he implement�at�ion of t�he enhancement�s ident�ified wit�hin t�he first� 4 point�s. it� is also t�he point� at� which t�he journey t�owards cult�ural change begins. the implement�at�ion of any new or enhanced pract�ice needs t�o be considered somewhat� separat�ely t�o t�he day t�o day management� of safet�y and risk management�. implement�at�ion ent�ails t�he int�roduct�ion of all or some management� syst�em element�s and changing one or more aspect�s of t�he organisat�ion including, in many cases, t�he cult�ure of t�he organisat�ion. the moment�um of t�he change program will oft�en need t�o be maint�ained over several years.


Point 5: introDuction of new AnD enhAnceD PrActiceS


the t�asks for t�his element� of t�he st�rat�egy will primarily fall out� of t�he implement�at�ion plan developed during t�he work associat�ed wit�h point� 1. each t�ask will correspond t�o each element� of t�he plan and will be t�he subject� of an act�ion management� plan t�o ensure t�hose responsible for int�ernal t�asks complet�e t�here assigned act�ivit�ies in a t�imely manner.

tasks to support the implementation plan activities include:

• develop t�he mid t�o long-t�erm implement�at�ion st�eps

• development� of a communicat�ions plan t�o all st�akeholders on t�he requirement�s of t�he implement�at�ion plan

• Secure and gain commit�ment� t�o t�he resources required t�o effect�ively implement� and follow t�hrough on each st�age of t�he plan

• review t�he development�al work achieved by early 2013

• development� of a change management� plan t�o support� act�ivit�ies t�hat� involve significant� process and pract�ice changes.

measuring t�he success of t�his st�age of t�he st�rat�egy will involve t�he evaluat�ion of mult�iple int�ernal syst�ems, processes, and pract�ice.

measures of the success of this stage of work include:

• increased level of mat�urit�y of each element� of t�he safet�y syst�em

• increased levels of report�ing wit�hin t�he safet�y report�ing syst�em

• A marked improvement� t�o t�he level of proact�ive report�ing of hazards

• increased skills levels of operat�ional st�aff in t�he process of assessing operat�ional risk

• implement�at�ion and cont�inuous use of t�he risk management� framework

• full int�egrat�ion of syst�ems and processes wit�hin t�he Safet�y and risk management� Syst�em.

While t�he above measures span a broad scope t�hey will be guided by a st�ruct�ured evaluat�ion process t�o ensure fidelit�y and veracit�y.


imPlementAtion PhASeSthe Aeromedical Safet�y and risk management� enhancement� St�rat�egy project� will ult�imat�ely lead t�o enhancement� st�rat�egies requiring implement�at�ion t�hrough t�he implement�at�ion plan developed in point� 1 of t�he st�rat�egy. the process of implement�at�ion will be comprised of t�hree dist�inct� phases. this phased approach has been designed t�o provide Ambulance wit�h a clear and succinct� approach t�o t�he enhancement�s, which delivers a number of crit�ical out�comes in a logical and t�ransparent� format�. transparency is required t�o allow each st�akeholder of t�he st�rat�egy t�o fully underst�and t�he process and desired out�comes, and a logical workflow is required t�o avoid change resist�ance in t�he early part� of t�he implement�at�ion of enhanced process and pract�ice, and avoid change fat�igue as t�he implement�at�ion period spans across t�he required t�imeframes t�o ensure full int�egrat�ion. each phase is described below.

PhASe 1:bASeline eXiStinG PrActiceS AnD iDentifY GAPS. november 2012 – mArch 2013

the first� phase of implement�at�ion is based upon gaining a clear and full underst�anding of t�he current� st�at�e of process and pract�ice wit�hin each syst�em t�arget�ed for enhancement�. this phase is analogous t�o an archit�ect� undert�aking sit�e surveys and environment�al t�est�ing prior t�o t�he designing of a building and t�he commencement� of it�s const�ruct�ion. unless t�his is well execut�ed even t�he best� foundat�ions may not� support� t�he desired const�ruct�. Project� personnel will t�herefore be required t�o gain a full underst�anding of ext�ant� organisat�ional and operat�ional syst�ems and how t�hey int�eract� and affect� t�he organisat�ions object�ives. element�s such as man-machine and man-syst�em int�erfaces will need t�o be assessed. from such an underst�anding it� is possible t�o t�hen compare t�he current� st�at�e wit�h t�he desired end st�at�e, gleaned from phase t�wo, and map t�he pat�hway bet�ween t�he t�wo. this t�hen focuses t�he import�ance on phase 2.

PhASe 2:StrenGtheninG AnD DeveloPment of StructureS. mArch 2013 – mArch 2014

As indicat�ed above, phase 2 of t�he implement�at�ion process is based around gaining a clear and full underst�anding of t�he end st�at�e desired from t�he enhancement� process. using t�he building analogy again, t�his is t�he same as designing t�he building and creat�ing det�ailed engineering drawings of it�s framework, specificat�ions and event�ual look via elevat�ion and sect�ion det�ail. this t�hen gives t�he client� and const�ruct�ion t�eam vision of t�he finished product� so t�hat� const�ruct�ion becomes a holist�ic pat�hway. the same holds t�rue for t�he design of change and growt�h, wit�hout� clear vision of t�he goal and object�ives, change resist�ance or, over t�ime, change fat�igue may result� in project� failure. this phase t�herefore involves filling t�he gaps found in phase 1 and rolling out� new process and pract�ice. Project� personnel will be required t�o provide t�ransparency t�o t�he design and object�ives of t�he end st�at�e so t�hat� t�he pat�hway t�o it� is unobst�ruct�ed.

PhASe 3: onGoinG imPlementAtion & mAturitY of enhAnceD PrActice. mArch 2014 – mArch 2015

the final phase of implement�at�ion, and t�he broader st�rat�egy, is t�hat� of cont�inual mat�urit�y of ident�ified enhancement�s. this is where our building analogy moves int�o t�he const�ruct�ion phase, where a confluence of skilled t�radesmen engineers t�he desired finished product�. implement�at�ion is no less a process of engineering a desired out�come. the physical insert�ion of enhanced process int�o exist�ing syst�ems and t�he t�raining of enhanced pract�ice will be direct�ed and guided by fully developed plans t�o mat�ure each syst�em, however t�he desired long t�erm influence of behaviour t�o support� new process and pract�ice ult�imat�ely remains an exercise of engineering a safet�y cult�ure t�owards increased mat�urit�y t�hat� support�s organisat�ional resilience and high reliabilit�y.


overSiGht AnD AccountAbilitYthe t�able below list�s t�hose business unit�s and individuals wit�hin Ambulance t�hat� have a relat�ionship t�o t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy by way of maint�aining oversight� and/or account�abilit�y. this t�able does not� list� every st�akeholder of t�he project�, but� inst�ead list�s t�hose wit�h a direct� oversight� funct�ion in relat�ion t�o process and pract�ice t�hat� may well be effect�ed by t�he project�’s out�comes and t�hose wit�h account�abilit�y associat�ed wit�h t�he implement�at�ion of t�he out�comes det�ermined necessary t�o enhance safet�y and risk management� wit�hin Ambulance.

StakEholDEr rolE/chartErchief execut�ive – mike Willis (Act�ing) Account�able t�o t�he direct�or-general nSW healt�h for corporat�e, clinical, and public sect�or governance in Ambulance

direct�or St�at�ewide Services – dr. ron manning responsible for oversight� and management� of t�he St�at�ewide Services division

direct�or Professional St�andards and conduct� direct�or of t�he unit� responsible for st�rengt�hening et�hical governance, managing disciplinary mat�t�ers, invest�igat�ions, serious grievances and prot�ect�ed disclosures

Ambulance Service of nSW execut�ive management� Board responsible for t�he delivery of ident�ified service levels, qualit�y, performance t�arget�s and major programs

Ambulance Service of nSW Advisory council Provides guidance and advice on legislat�ive requirement�s and communicat�ion decisions

Ambulance Service of nSW Audit� & risk management� commit�t�ee Provides assurance enabling management� t�o recognise, underst�and, manage, and effect�ively cont�rol risk

Ambulance Service of nSW clinical governance commit�t�ee Provides a formal clinical governance funct�ion including incident� report�ing, clinical qualit�y and pat�ient� safet�y

Ambulance Service of nSW finance commit�t�ee responsible for t�he provision of a formal financial governance funct�ion

Ambulance Service of nSW operat�ions responsible for t�he delivery of front� line pre-hospit�al care, medical ret�rieval and healt�h relat�ed t�ransport�

Ambulance Service of nSW St�at�ewide Services division responsible for Aeromedical and healt�h emergency management� unit�s

Ambulance Service of nSW Aeromedical and medical ret�rieval Services division responsible for t�he management� and oversight� of t�he Aeromedical operat�ions cent�re (Aoc) and medical ret�rieval services, including fixed wing aeromedical services and rot�ary wing aeromedical services

note: cont�ract�ed operat�ors t�hat� supply Ambulance wit�h aviat�ion services hold significant� responsibilit�y for t�he success of t�he st�rat�egy, however t�he t�able above ident�ifies only int�ernal st�akeholders. each cont�ract�ed organisat�ion must� ensure t�heir role and responsibilit�y is accept�ed and underst�ood.


implementation of the outcomes of each of the five points will be achieved through a three phase approach to best ensure success:

01. Baseline exist�ing pract�ices and ident�ify gaps

02. St�rengt�hening and development� of St�ruct�ures

03. ongoing implement�at�ion and mat�urit�y of enhanced Pract�ice

the st�akeholder expect�at�ions and t�he need for robust� and effect�ive governance, combined wit�h equally st�rong legislat�ive requirement�s around dut�y of care, drive t�he primary object�ives of each of t�he five point�s of t�he project�, and each phase of implement�at�ion of t�he enhancement� of Aeromedical safet�y and risk processes and pract�ice, out�lined wit�hin t�his booklet�.

the proud hist�ory of Ambulance and it�s core values result� in an organisat�ion t�hat� holds, as one of it�s key drivers, t�he int�ent� t�o cont�inually improve performance and value t�hrough opt�imising organisat�ional st�ruct�ure, business processes and syst�ems.

the combined skills and commit�ment� of bot�h Aerosafe and Ambulance augers well for a unique part�nership t�hat� will ensure t�he ult�imat�e success of t�he Aeromedical Safet�y and risk management� enhancement� St�rat�egy. this success wit�h provide every st�akeholder of Ambulance, from pat�ient� t�o st�aff and t�hrough t�o government� and t�he wider nSW populat�ion, wit�h t�he assurance of a safe and high qualit�y service t�hat� t�hey seek and expect�.

this assurance will be achieved through the five point plan to execute the strategy which covers the following activities:

01. St�rat�egy and implement�at�ion Planning

02. governance/risk framework

03. St�rat�egic risk Profile

04. operat�ional risk management�

05. int�roduct�ion of new and enhanced pract�ices

concluSionAmBulAnce hAS A SimPle PhiloSoPhy of excellence in cAre thAt iS BASed uPon A commitment to high QuAlity clinicAl cAre And SAfe And efficient AeromedicAl oPerAtionS thAt Are conSiStent With itS miSSion And viSion.


contActSfor more informat�ion on t�his enhancement� St�rat�egy please cont�act� t�he following project� t�eam members:

AmbulAnce Service of new South wAleS:

julie morGAn – Project Director Phone: (02) 9320 7367 email: [email protected]

AnnA roZArio – Project Manager Phone: (02) 9320 7364 email: [email protected]

AnDrew rYAn – Station Officer and SME Phone: (02) 4256 3823 email: [email protected]

AeroSAfe riSk mAnAGement:

kimberleY turner – Chief Executive Officer Phone: (02) 8336 3700 email: kt�[email protected]

clive ADAmS – Chief Operating Officer Phone: (02) 8336 3704 email: [email protected]

melvin SAmuel – Project Manager Phone: (02) 8336 3709 email: [email protected]


DeveloPeD bY:aEroSaFE riSk managEmEnt Suit�e 5. level 1. 40 lord St�reet� Bot�any nSW 2019 Aust�ralia t. +61 2 8336 3700 F. +61 2 8336 3799www.aerosafe.com.au

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