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Medical Flight Safety Takes Center Stage in DC

Scott Wallask, for HealthLeaders Media, April 22, 2009

This morning's scheduled Congressional hearing on medical helicopter services is the latest in a string of discussions this year centered on the safety of EMS flights and the well-being of patient passengers.

The meeting by the House of Representatives' Subcommittee on Aviation appears to be mostly a fact-finding mission about medical helicopter safety in recent years rather than push for more regulations, says Rex Alexander, a director for the National EMS Pilots Association and the regional operations manager for Omniflight Helicopters in Fort Wayne, IN.

"Personally, I don't see anything happening [at the hearing]," Alexander says, adding he is most interested in whether lawmakers on the subcommittee make recommendations for improvements.

Meanwhile, on Monday, the Flight Safety Foundation—a nonprofit group that aims to improve aviation safety—released a 64-page report outlining 26 major risks in the structure and oversight of the medical flight industry. The document also highlights possible steps to offset these risks, with the caveat that it is up to various parties involved in medical flight services to help make changes.

"This is a great opportunity to educate hospital executives if they [lead] a sending or receiving hospital" involved with air transport of patients, says Kimberley Tucker, CEO of Aerosafe Risk Management, which has U.S. offices in Washington, DC. Aerosafe prepared the new report on behalf of the medical flight industry. Regarding today's congressional hearing, Turner says she'd like to see lawmakers examine the opportunities for the medical flight industry and other industries, such as healthcare.

Based on the likelihood of problems occurring and the severity of related consequences, the three highest-ranking concerns in the report include the following:

  • A lack of a national framework to govern medical flight services, which leads to relaxed accountability, challenges to gaining agreements on best practices, and reliance on flight operators to make decisions regarding patient transport
  • An inadequate medical reimbursement model, which delays upgrades in equipment and technology
  • Little clarity about the roles of federal, state, and local agencies involved in medical flight oversight, which results in conflicting rules that may confuse flight operators

Currently, laws, codes, and regulations governing patient flights vary from state to state. Nine fatal medical flight accidents have occurred since December 2007, killing 35 people, according to the National Transportation Safety Board (NTSB). The NTSB lists enhanced safety of air ambulance services as one of its most wanted transportation safety improvements for aviation.

The NTSB has been pushing the Federal Aviation Administration (FAA) to enforce more aggressive medical flight regulations. The NTSB held hearings in early February to question the parties involved in some of the 2008 medical flight crashes and discuss recommendations from various stakeholders.

From its perspective, while the FAA is willing to lend its expertise to hospital and business challenges related to medical flights, the agency's regulatory responsibilities are limited to aviation, says spokesperson Les Dorr.

Representatives from The Joint Commission helped review a draft of the Flight Safety Foundation report earlier this year, and in doing so fleshed out patient safety and risk management practices within the document, Turner says.

"Acknowledging the problem and identifying risks are critical first steps toward finding solutions to accidents that have plagued helicopter emergency medical services," Jerod Loeb, PhD, executive vice president of the Division of Quality Measurement and Research at The Joint Commission, said in a press release issued by the Flight Safety Foundation.

The report's developers have set an August 31, 2009, timeline for a risk reduction plan to be formally released to the medical flight services industry. Until then, stakeholders—including hospitals—have an open invitation to create and submit solutions, Turner says.

For more information about these submissions, contact Katherine Robinson, communications and senior planner at Aerosafe.


Scott Wallask is senior managing editor for the Hospital Safety Center. He can be reached at swallask@hcpro.com.

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