Dan Rose is the Manager Clinical Hub for St John WA, focusing on enhancing the service delivery of clinical triage and clinical support within State Operations. He holds an MSc Advanced Critical Care Practice (Warwick) and a BSc (Hons) in Paramedic Emergency Care and various postgraduate awards.
Unrestricted Clinician in Odyssey. An Australian First in Secondary Triage. Why. How. What.
Mr Dan Rose1
1St John WA, Belmont, Australia
Abstract
Background
Triple-zero secondary triage systems are established across Australasian ambulance providers to manage lower acuity cases and connect patients with appropriate care.
St. John Western Australia (SJWA) implemented Odyssey in late 2023, configured to ‘Restricted Clinician’, requiring strict questioning compliance that mitigates risks to patient safety yet prolongs triage cycle times. To optimize efficacy, whilst still mitigating safety risks, SJWA explored progressing high-performing triage clinicians to ‘Unrestricted Clinician’ in mid-2024.
We also considered the trajectory to implementing video-triage in mid-2025, anticipating the organic nature of unrestricted enquiry could influence better engagement and outcomes.
Actions
SJWA initially employed Ambulance Victoria’s audit tool for case review. Select high-compliance clinicians (>90%) were identified for unrestricted status.
Various parameters were agreed, including thresholds for reversion to restricted status (e.g. audit scores <80%, leave etc.).
Clinicians attended bias and critical thinking refresher training. We also ran simulated cases to further develop workflows.
Unrestricted audit frequency was increased to detect unanticipated risk and measure compliance. We also monitored 24-hour call-backs.
Results
- Triage cycle times improved by ~20%.
- No increased incidence of 24-hour call-backs.
- Diversion increased.
- Unrestricted compliance remained high.
- Audit tool required contextual refinement.
- Remaining restricted users’ compliance rose.
- Better identification of problematic cases (e.g. sepsis).
- User satisfaction improved.
- Surge resilience enhanced.
Conclusion
SJWA is the first jurisdictional Odyssey user to authorize unrestricted status. Planning was effective, improving triage efficacy without undue increased risk.