An evaluation of the Public Access Defibrillation (PAD) Demonstration

5.2 Commitment of host organisations to PAD

Page last updated: August 2008

Commitment amongst host organisations to the PAD Demonstration varied. Those organisations that had that actively sought out St John (or had purchased the AEDs themselves) were highly committed to participating in PAD, and reported the following driving factors behind their commitment:

  • Experienced a sudden cardiac arrests at the organisation previously

  • Viewed the AED as part of the organisation's duty of care to staff, customers and general public:
    First and foremost it's an organisation commitment to OH&S. (Manager, tourist attraction)
  • Their customers or patrons tended to be older and/or

  • Participating in a PAD program was seen as 'good corporate citizenship'.
Strong commitment was also evident at host organisations where staff had campaigned (unsuccessfully) for the installation of AEDs for many years prior to the PAD Demonstration. These respondents were extremely committed to providing access to early defibrillation in their organisation now that the AEDs had been installed.

Organisations who had been approached to participate in the PAD Demonstration by St John project managers were less committed to involvement in the program in the long term.

There was a higher level of commitment to, and perceived value of, the program in those organisations that actively sought out St John (or had purchased the AEDs themselves) compared to those who had been approached to participate.

5.2.1 Ongoing installation and AED maintenance
5.2.2 Financial commitment to the installation of AEDs
5.2.3 Non-PAD demonstration AEDs

5.2.1 Ongoing installation and AED maintenance

Ongoing installation and AED maintenance was generally perceived by managers and staff as 'fuss free', easy and low cost. However, at some organisations, where the AED had been installed for a number of years, maintenance checks were reported to have reduced. Over time, staff and management had become unsure of exactly how often maintenance check should be undertaken, and some were unsure of what the checks involved.

Just the maintenance of the unit. I think it requires weekly checking, but I don't think we have been as vigilant. Not checking it regularly and I don't think anyone has signed the book to say that it has been checked. (Manager, national park) Top of page

5.2.2 Financial commitment to the installation of AEDs

When asked if the private market could sustain a PAD program if government funding was not available, a number of managers said 'no'. Lack of financial commitment was especially evident for smaller organisations, who reported more pressing occupational health and safety priorities. The purchase and installation of AEDs would not have been a priority for these organisations if they had been required to fund the cost of the units, training and implementation themselves.

I don't think management would have paid. Small businesses with high overheads can't really afford it. Not legally necessary to have one in a gym, so it's not likely to be privately funded without legislation. (OH&S manager, fitness club)

We are committed, but not likely to fund ourselves. If funding was not available this would not have been a priority for us. (Manager, yacht club)

I don't think government should be funding this. I would like to see organisational management understand the benefits and see it as their duty of care to provide these units. (Manager, state national park)

Conversely, a number of organisations were financially committed. These businesses had already invested in additional devices. Such organisations tended to be larger, busier environments or sites where there had been fatalities from sudden cardiac arrest prior to the installation of the AED, or activation of the AED had saved a life. The initial funding from government had acted to demonstrate the value of AEDs as live saving tools to these organisations. These organisations stressed that they would continue to install AEDs, even if government funding was no longer available.

The government funding gave the incentive for us to move forward. We have since purchased four more units and we now have staff at all of our office buildings requesting them to be installed. (Manager, local council)
Financial commitment to AEDs differed amongst host organisations. For some, the devices were too expensive and not viewed as a top health and safety priority. Others believed they were essential, and had already purchased additional devices. Top of page

5.2.3 Non-PAD demonstration AEDs

Organisations that had privately purchased AEDs were included in the consultation to gain further understanding of the factors driving the private purchase of the devices.

As with the government funded PAD Demonstration, AEDs at these organisations were typically installed under a trained first responder program. At each of these organisations, AEDs were considered by management to be an essential element of the company's duty of care to its staff and public. The driving forces behind the decision to purchase the devices varied, from ensuring occupational health and safety for staff to senior management having personal experience with cardiac arrest.

Some examples of privately funded early responder programs included:
  • A large university (with five campuses and over 30,000 students)
    At this university each campus had an annual budget of $4,000 to spend on occupational health and safety services for the entire campus. The notion of AEDs was raised as an option for the expenditure of these funds at a regular OH&S meeting.
    The university purchased one AED for each campus. Campus first aid staff were trained in the use of the AED and all staff and students were informed of the AEDs via the intranet and signage around the sites.
    The devices had been installed for five years with no activations.

  • Casino in a large metropolitan city
    The previous owner of the casino had a serious heart condition and had driven the installation of AEDs in his businesses.
    20 devices were installed throughout venue. All security guards (permanent and contract) are regularly trained in the use of the AED. Devices are kept with other emergency equipment, ready to be moved to the scene by security first aid staff in the event of an emergency.
    The manager estimated a response time of less than two minutes to any location within the casino.
    The AEDs were installed in 2000. There have since been 15 activations, 10 shockable rhythms and six lives saved (until ambulance handover).
    AEDs were perceived as core to the casino's duty of care and were now fitted as standard in all new hotels and building extensions.
The key lesson identified by these organisations was that early access defibrillation requires commitment of senior management. Dedicated first aid staff are essential and the training and use of the AED must be incorporated into standard public liability or health and safety practices.