An evaluation of the Public Access Defibrillation (PAD) Demonstration

4.5 Issues and lessons identified by stakeholders

Page last updated: August 2008

The success of a public access defoliation programs rests on access by any member of the public to an AED. Stakeholders stated that the Australian community were generally unaware of AEDs and their benefits. Implementation of community awareness campaigns was strongly advocated by stakeholders as an option the government should consider. It was also noted that any information campaign to improve awareness needed to emphasise not just the benefits of having the AEDs available in public settings, but also the actions people should take in the event of a cardiac arrest and the safety of using AEDs.

It is giving people permission to use these things … that’s the scary part, that they don’t feel that they have permission to use the AED. (Stakeholder)
The private sector's fear of litigation was viewed as a major stumbling block to the expansion of early access defibrillation. However, stakeholders felt this block could also be turned around by an informed communication campaign targeted at the private sector.

It is a matter of 'tweaking the message'. Turning the concept of AEDs into a more positive concept, that having an AED installed on site can save a life, rather than 'using an AED will open an organisation up to liability and litigation'. (Stakeholder)
Stakeholders identified a need to increase awareness amongst the private sector that an AED is a crucial piece of emergency equipment, and not a great expense when the cost-benefits are considered. The infrequency of cardiac arrest events was acknowledged as a likely deterrent for private businesses making the investment in AEDs. However, one stakeholder used a comparison of AEDs to fire extinguishes to emphasise the importance of AEDs as a life saving device for infrequently occurring emergencies.

If you have that approach 'where it won't happen very often so why bother' you would have to take out the fire extinguisher and stop your insurance for damage from floods etc. (Stakeholder)
It was strongly suggested that government could take a more active role in spreading the message that AEDs should be installed as a standard duty of care in (particularly in larger organisations). Stakeholders believed an active communication campaign was needed for AEDs to become the standard of care for public liability and workplace safety.

Stakeholders acknowledged that regulation was another option that could be explored to increase the installation of AEDs, and shift the financial onus from government to the private sector. However, they warned that regulation alone would not act as an incentive for organisations to install AEDs.

More inclined to say – here is an incentive program, but there is a strong requirement that if your organisation is a public place, that it is a duty of care that a level of safety is provided. Any kind of stadium has to provide first aid cover, have to be able to provide basic level of medical care. Why can't AEDs form part of that requirement? (Stakeholder)

Legislation will just mean that people could install them, but not necessarily comply. (Stakeholder)

Other factors suggested by stakeholders to be taken into account when considering the future of the PAD Demonstration included:

  • The possibility of stronger role for state governments in regulating and funding early access defibrillation:

    The states can play an enormous role. They provide healthcare at a state-based level, and they are responsible for delivery of adequate healthcare and public safety. (Stakeholder)

    I think things are better when they are jointly done between the various parties ... and a hybrid model between states and federal is a nice incentive program. (Stakeholder)
  • That ambulance services would be best placed to take over the governance of the program, and to oversee performance monitoring:

    The agency that has the most influence in public access defibrillation is the ambulance services. Ideal would be for ambulance services to be responsible for first aid governance, for the implementation of PAD and monitoring. (Stakeholder)
Lack of awareness of the benefits of AEDs amongst private business and the general public, together with misplaced fear of litigation, were key issues identified by stakeholders as affecting the ability of the PAD Demonstration Program to expand beyond its current role.