1994 communications survey

SURVEY

1994 Communications Survey Geoffrey Cady, Research Director, Emergency Care Information Center Efficient and reliable communications are essential to the operation of any business. But perhaps in no other environment do they play a more critical role than in air medical missions. The accurate communication of scene and patient information, weather conditions, landing zone location and hazards, as well as the need for routine updates r e g a r d i n g patient condition, are essential for safe and successful missions. The communications centers play a pivotal role in coordinating and disseminating information to each component of an air medical team. In response to this critical role and rapid developments in telecommunications technology, the Air Medical Journal again has asked communications specialists to complete a communications survey for 1994.

This year's survey continues to build on data obtained in prior years. One h u n d r e d seventeen r e s p o n s e s were received, prior to the survey's deadline, for a 43 percent response rate. For the p u r p o s e s of comparison, data were extracted from the 1993 Communications Survey published in the 1993 November/December issue of the Air Medical Journal. Data not available for comparison (because some questions were not asked in the previous year) in the 1994 tables are noted. And, as with all data analysis, rounding error will be present in some instances. As in previous years, the survey is self-selecting. Therefore there may be bias associated with the respondents who chose to complete the survey in contrast to those who did not. Relatively

small changes in percentages (five to 10 percentage points) should be interpreted conservatively. However, even with these limitations in mind, the survey results present a snapshot of the present configurations and operations of air medical communications centers in the sample. Descriptive data regarding the location and staffing of program communication centers can be found in Table 1, as well as methods or mediums used to request and dispatch air medical resources. Next, Table 2 presents a list and use rates of equipment typically found in communications centers. Of interest in this year's survey was the finding that 20% of respondents are using UNICOM for medical communications A description of "Communications

rable -

Communications Center 1986

1990

1992

1993

1994

73% 14% 12%

83% 15% 2%

84% 8% 8%

85% 12% 3%

85% 6% 9%

Communications Console Location

Separate communications center Emergency department desk Other Communications Center Staffing

Communications specialists Employed by program Outside contract Emergency department nurses Other

78%

--

--

90%

92%

---

69% 13%

79% 9%

74% 9%

72%

8% 13%

8% 10%

4% 8%

11% 5%

28% 4% 4%

75% 11% 1% 13%

93% 5% 1% 1%

93% 4% 1% 2%

91% 7% 1% 2%

90% 4% 4% 2%

Incoming Call Reception

By communications center By emergency department By specific clinical unit Other Phone Numbers for Incoming Calls

Dedicated local number Toll-free communications number Hospital switchboard Ring down lines from public dispatchers Other

Air Medical Journal

13:11-12 November/December 1994

--

80%

77%

62%

68%

86%

88%

91%

93%

93%

----

7% 28% 8%

4% 24% 4%

3% 22% 8%

6% 20% 6%

487

Procedures" is in Table 3. In this year's survey, launch decision processes for scene and interfacility responses were compared. The communication specialist is responsible in 64 percent of the programs when aircraft were responding to scenes, in contrast to 36 percent for interfacility responses. (This is under the assumption that weather or other operational decisions are not a factor, and tlie pilot has the final authority.) Table 4 presents data related to the training, scheduling, responsibilities and salary ranges for surveyed communications centers. The last question of the survey was open-ended, and asked respondents to report on the two most significant challenges that are faced by air medical communication specialists? A review of these handwritten comments found several reccurring themes. The most frequently observed theme this year, as well as last, is a desire for more professional recognition as part of the flight team. Recent moves at forming consortiums to control costs and to reduce nonproductive regional compefi-

tion have resulted in a rise of multi-aircraft, air medical programs. Communication specialists now are tasked with the efficient allocation of air medical resources, as well as with the responsibility of monitoring the safe operation of aircraft through flight-following activities. The increasingly complex environment faced by the communications specialists appears to be supported by recurring requests for more training, with training specific to flight-following techniques reappearing throughout the specialists comments. Additionally, just as the ground ambulance industry has been forced to deploy its resources more efficiently in an ever increasingly costconscious health-care environment, so have air medical services. Efficient resource allocation in health-care environments requires comprehensive monitoring of system practice and consistent execution of resource allocation protocols. Repeated requests for training that would assist in the triage of requests for air medical services emphasize the need for systematic launch decision protocols

appropriate for the air medical industry. The disproportionately high cost associated with rotor-wing aircraft start-up and shut-down supports the economic need for the development of such protocols. As air medical p r o g r a m s work to increase the appropriate utilization of program aircraft, technology increasingly will be needed to more efficiently allocate scarce air medical resources. Again, comments from communication specialists echo the need for improved dispatch and flight-following technology. The same economic pressures facing the ground ambulance industry are bearing down on the air medical industry. The transfer of cost-saving technology that has been instrumental in the com: petifive success of many ground-based systems could provide the competitive advantage for air medical programs. However, perhaps the most significant change behind the improved performance of emergency medical systems was the responsibility and authority given to air medical communication specialists to manage system resources.

table : Communications

Equipment

1986

1990

1992

1993

1994

--

65%

71%

68%

73%

--

5%

8%

0%

1%

--

46%

46%

38%

--

Both VHF and UHF

--

13%

15%

9%

--

Other

--

3%

4%

5%

--

Radio Equipment (Transceivers) Console Both

Primary Frequencies for Both Dispatch and Medical VHF

Primary Dispatch Frequency VHF

50%

Both VHF and UHF

2%

Other

2%

Primary Medical Frequency VHF

41%

Both VHF and UHF

5%

Other

2% continued on next page

488

Air Medical Journal 1 3 : 1 1 - 1 2

N o v e m b e r / D e c e m b e r 1994

T a b l e 2 continued 1986

1990

--

32%

1992

1993

1994

30% 3t% 4% ~ 10% 3%

33% ~ 2 7 ~.... 9% ~ ~ : .... : : 9% 5 % ' : :

Primary Frequency Is: Discrete: Air medical program only EMScontrol Hospital net UHF medical channels ........ Combinations of the above Other '

39% 3:~% : : 5% ' '0 ..... 8% '-, 3% :"'

: -.....

6% ~ 16%

.... --

,

;

,

"

'

'

'::

Programs with Unicorn Yes

.

NO

'

.

.

'

.

,

69%

.....

~

........

~

.........

3i%

Do you use Unicorn for Medical Communications? Yes No

.

.

.

.

:

19% 8 0

:

~:

Additional Equipment 24-hour continuous recorder: Radio only Phone only B o t h radio and phone None V0ice~aCtivated recorder: Radio only Ph0neony : Both radio and phone

64%

..... .

.

.

:: .

None Call checWinstant playback:

.

'.

;

.

, .

;,~

--

.

.

-0% , :~, .... 8 ~° . . . . . . . . :~ 3% , . ~:: . . . -2% 2~ ~:tl -17%

...................................... ,,, , 45%

Radi o only : : Phone only Both radio an d phone .... ..... None '; Phone p a t c h capability Frequency scanner :: Portable t w o - w a y radios; Duty pilot :: ,;' Program director Duty medical crew : : On-call administrator : Closed circuit helipad monitor: , :', Monitored by security : Monitored by communications Monitored by t h e eme[genCy departmeat . Monitored by direct visual observation from communications director or ED . . on . .a arm . . system . . . . . . . . . . ,. . H e p. a d. . ntrus Other monitoring system No monitGing system

--

86% 6?/8 3%* 8 6~/8:

:::

....... ::

::.

.

.

.

.

, :~ --

:,

=

~ 40%

D%L

13%

,:

i

62% 62%

70%

;

6

6

!

44% "!~ : 1,28% -56% :. --.~ , : .... ,1~%1 -60% . . . . . . . . .---~ ......... * :: 3 -55%* . . . . . . . . . . ~~ --

22% '

i

--

....

. . .~2 . . ° ...... . . . . 9%

15% ~° ..........

.................................

;

{

.....

24%* 6 3 % :' 61% 75% 71%* 20%~ ! ,

% 65% :7'6% : 68%* 25%~

i 48% ', i ~ : ~" : 61% 91%* 80%* .... 9% 12%~ ...... :8.%~: -70% 73% ...... :, 5 i :~~ , . . . . . ;.... ,,:: G6 o~.......... , , .... ; # 3 o~ ~ ....... ........ 56% 78%* 80%* ~ . . . . ...... o , , .......... 0 *

--

-~. . . . . . . .

;

i'

......

.

,,,}

:

19%*

, =

.

70% 70~!t;

:!:5~

28%*

,

.

~#~ 43% :

0%

;

.

. .

.

;

3%* ..... ' ' ':: , :. .,. .3. . . 0 %, 2%* 6 % ! :~ 42%*

. :~:, ~: ~ 49 ~ 1% 10%* : , ;~,}0%"ti:~ : B % ~ 18% 39%*

--

--

,

.

...........

,{

:::

1% ~ ° .....

88% 0%~ 8%* 8 8~Y o~

'

o

25%* 1% ' 3% ~3 ~

25%* t ~ . . . . . ......... 3% '

1

'

Adequate Two-Way Communications with Helicopter Occurs: Less than 25% of all flights 25-4-9% of all flights 5 0 - 7 5 % of all flights M o r e tha~ 7 5 % of ali flights

1% =

. . . .

0%

o

=

10% ........ . . . . 85Yoe,

....

0% =

;

16% .......~9~%

0%

1% 2 ~o 9% 88~,

o

8% ...........g l o ~

7% ........... 9 2 o: ~ ....

Written Flight-Following Procedure Yes NO in process of writing

:

..........

95% 96% 5 ~. . . . . . . . . . . . . . . . .:!2% ..... --

2%

38% 5i% 9%

42% 59%:-.: 3%

:

97% 1% 2%

97% ........20 .........

89% !i% 0%

1%

;

Time Interval for Flight Following 5 minutes 10 minutes 15 minutes 20 minutes or more

; ' ::::::::t:i

::':::::: i

:::

48% . . . . : 5 2~ : . . . . 0%

; 46% 5~:~:: 3%

;:;;' 46% 53%: 1%

*Percentages in subcategories represent percentage of overall responses.

Air Medical Journal

13:11-12

N o v e m b e r / D e c e m b e r 1994

489

Fable

C o m m u n i c a t i o n s Procedures 1986 Launch Decision for Helicopter (All Flight Types) (Assuming pilot has final authority) Communications specialist !mpat!e~tunitRN orMD; : : ;i / ED physician or nurse

43%

41%

18%

15%

51% % 11%

--

18%

11%

1

Combination of above

Launch Decision for Helicopter to Scene Communications specialist : : !n-pat!ent Unit RN:o~ MD ,, ED physician or nurse M e d i ~ a l f ! i g h t c r e w ! ::: [ [t~ :[, : i; ! Combination of above }i[ Other ;

43% % I3%

-~ i --

;

13%

--

6% ;

:::, ;:

[ :

57%

,

. .

', ::'

70%

-~;i: : _

36% 2~ 23% 2% 17% 0 %

' ii

i: .

60% ~% .

. .

-: ~ 'i~ !:~2~% 11%

i

8% 8% ;~

80%

80%

77%

50% ~%

52% 4%

58% i ~ % 25%

29%

26%

23%

7%

3%

38%

42% '3 %

43% %,

~18%[ 10%

14% * :;,'~3~

38% : : [~

Patient Acceptance Policy Helicopter is launched upon request, response hospital assumes responsibility for patient acceptance

56%

30%

31%

35%

32%

Helicopters not launched until receiving physician formally accepts patient

2t %

22%

22%

17%

18%

23%

18%

19%

18%

11%

Other

490

~

1994

64%

Hospital paging system: -Of those who use hospital paging systems: A c c e s s fra~ 6~mmdnic~ti~:~6~nt~:~i ;, i~ 'i '!~ :,,~ i. ~ :',; ~, ~23%; Must call switchboard 7% Portable radio : Othe~ [

1993

:

Alerting Flight Team Flight program paging system: Of those who have flight paging systems: Voice To~e6ny Dedicated program paging system

:

:~

Launch Decision for Helicopter Interfacility Transports Communications specialist !n~Patent unt RN or MD ED physician or nurse M#dicat f!igHt c r e w ' : ' ,:; :: : ,~ Combination of above : :OtHer

.....

1992

1990

!

'

::

Air Medical Journal

13:11-12

I

November/December 1994

rable

Communications Personnel 1986 Number of Communications Specialists Three full-time Four full-time ;! ; i :~, Five full-time Sixfuli-time ! [~ [ : Seven to 12 full-time ~artBime:;: } :3/i,

22% ~:';,24%~;'.'~: 26%

;;

.

.

.

1992

1993

22% ,~2~',' 26%

16% 3:~ 12%

14%

;: .

.

.

18% ~ ,~;i . ~ 14% ;i ;9% '~ 23% :q3% .:

16%

:!; .

'~ i:' 8~%!:1~i

67%

66%

57%

2%

3%

0%

15%

15%

12%

2% ,,:'~5~ 16%

;i,

.

1994

'.~i

B2/0A

Communications Specialists Level of Medical Training EMT trained 65%

Nurse : : Me~cateffmnbdgyCourse No medical training required

1990

63% 1% ::W%:~ 8%

............

:

Communications Procedures Training Medical terminology training ~ M S / A C S tra!n!ng APCO basic telecommunication course P~iorit'y card: training[ '} : Observational flights : No format training requ!red : / : [ [ Other training

14% ::

i:

38% ;::::!i:~ %:'

s:

-,~1i~9/o --

[

-~ 4 % ? i::

26% 29% :'~:~;,i:i!{i,~:Z~%"~t : : i . , 49% 52%

-2%

-20% 5%

23%

35% ~ 77%

' ~ , '! 73%

}

,

~, I

,

]

i

Duty Shift for Communications Specialists

8 hours

....

10 hours .... 12:h0urs Combination of eight and 12 hours

10%

2% ':~!44% 10%

:~i£;@/o:

,b;'~:i:~:~:o°£i~#i

Additional Communication Specialist Duties Ground EMS dispatch

--

44%

40%

46%

63%

Poison control

4%

7%

4%

3%

2%

--

28%

19%

19%

18%

--

40%

40%

48%

41%

. . :' ~ ~' :{ .~ i, .~ ~ ;~ ~ 53% 51% 51% ;i;.ic. ~; :i 0°/6 i!};:1~%ii ':~'~ ~13 17% 11% 20%

6% ;~2 8 % 45% :~:' '., ~:2 16%

:t

:i

3% :

.;

i

,iiLi

H.E.A.R./Telemetry

None:

:~ :~%x ;;~::u~,

5% i 20%

:

:5

:~i z~

11

Other

;

2% 1% ; ~ ::~I~/~:;: ~:'i~.!:.~: ;:49% 13% 20%

Communications Staff Supervised By: Eutl-time ; Part-time Do not have c0mmuhi~ationssupe~isor Communications supervisor Ch!ef f!ig~t :nurse : [ [;: ~ i ' ! '. Program director :COmbination of ~he above Other

. ,:~ ~1

.

~,

-:, ---

9%

11%

8%

12%

continued on next page

Air Medical Journal 13:11-12

November/December 1994

491

T a b l e 4 continued 1986

1990

1992

1993

1994

2% 1%

0% 4%

0% 0%

Annual Salary for Communications Supervisor Under $10,000 $10.000-$14 999

--

0% 4%

$15.000-$19. 999

--

18%

18%

10%

5%

$20,000-$24.999 $25.000-$29 999

---

28% 20%

22% 32%

15% 13%

'33% 12% 2 6 oY o . . .

$30.000-$34.999

--

-

5%

14%

17%

$ 3 5 . 0 0 0 - $ 3 9 999

--

15%

"1%

14%

$40.000 and over

.

.

.

.

12%

.

X t 6%

. ,~

Full-time Communication Specialist Salary $10,000-$14,999 $15000"$19999 $20,000-$24,999

42%

20%

: --

$25,000~29;999 $30,000-$34,999

.....

5%

4~% 29%

4 3 % 36%

~3% --

$ 3 5 000-$39 999

9%

50% --

:

[

2% :

$40,000 and over

.

3% 34% 38%

~2% 2%

--

......... 5%

: :: [ :

6%

.

.

.

:

1%

Part-time Communication Specialist Wage Minimum

....

Average Maximum Standard deviation

492

:

::::

$ ~ i

$45Q

$375

$500

$6.95

$7.89

$8.94

$8.84

$!6:00

$170d

OD --

:::

$~275 --

:

:

--

Air Medical Journal

;

$6~00

$1.88

~;SD

;

$9.17 $2.40

13:11-12 November/December 1994

~ ; E RU NVI TIE DC SET A, T~E ~

Statement

of

Ownership,

Management,

and

Circulation

(Required by 39 U.S C 3685) 1 p~bl~a~i~ T~tl~

~

Publio~i~ 2 NO

AIR MEDICAL JOURNAL

9/29/94

VJ.da R o b l e ,

Suite

200,

Carlsbad,

San Diego

County,

'5

October

E=ent and Nature of Clmulafion

].994

Average No. Co# es Each Issue During pre~e,~n812 Menth~

~¢t ual N~, e~pies of S~ngle Issue published ,'4earest to Hffn9 Date

b p~J~and/or Requested Circulation (1) Sates Through Dealers ann Carders. Street Veneor~ and Counter Sales

7. C ~ p l e t e Mail~n~mdress of Known Office of ~ob~[gation(Affect, City Co~l~ State a ~ ZIp+4) ¢NotpnnferJ 1947 C~ino

AIR M E D I C A L JOUP~NAL

~ F~ling D~te

Ca 9 2 0 0 8 - 6 5 5 . 5

(2) Paid or Requested Mall Subscrlpl]ons

4,465

4,5SO

4,465

4,~90

8 ~mplet8 Mm~n£ A~ress of Hee~qua~ers or Gene[~ Business O~ice or PubNsher ~ o f Prinre0 e Total p~8 a~mo, ~ q ~ e ~ e e Ci,=~at~on S~e

~Sumof ~sbH)e ~ ~5~(gJ)

~S a b o v e

9 FUll Names and ~mplete Mgllin~ Addresses ef publish° r, ~d~or, ~ a ~ l l ~ , publisher f~ame ~

J~es

r~o ~or Lea~o Bfa#k)

(SampCes.Complimenta~~nd OtherFree)

CampCeteMaZ/~q Ar fciress)

O. Page, P.O. Box 2789,

Carlsbad,

373

381

650

852

1,023 5,488

1,233 e 5, ~23

568

555

i 7olal (Sum o£ l ~ IS°U), aresIsh(2))

6 t056

6,378

rear.at Paid and/~r Requested Circ,°liOn

81.36

e Free Distribute° Outsi6* Ihe Mail (Cartie~ orOmerMeansJ

Ca 92018

£fliler(Name nod com#I~te Mal#ngAaams)

-Oral Free Distribution {Sumof 75dand fSe)

Kelth Griffith~, P.O. BOX 2789,

Car!~bad,

Ca £20lS

TolalD~stnbution(Sum O¢ 15C and ~50

Ma~agin~ Editor(Name~nd C,or~gete MaflfdgAdams#

Laura Gilbert,

Association National

~.0. Box 2789,

of Air Medgcal

Flight

Par~edics

Carlsb~d,

{I)O~=e Use. Leftovers, Snolle a

Ca 92018

So,ices

P.O. Box 2789¢ Ca~isbad,

Ca 92018

Association

P.O.

Ca 9 2 0 1 8

BOX 2 7 8 9 ,

Cazlsbad.

16Th]sStatementofOw~ersh]pwff[beplintedinthe

N/D issue

7 S~gnatu'e a~d ~3tle cl Editor, PubffsheL Business Manager, or e ~ c

National

EMS pilots

National

~li9ht ~oxses

Association Association

p.O. Box 2789, Carlsbad,

Ca 92018

P.O.

Ca 9~01~

Box 2~89# C ~ r l s ~ d ,

d

1 L K , ~ Bondholders. Mo~ga~ ees, and Other Security HoWers O ~ i n g or H01ding1 perce~t or More ot Total Amount of Bones, Mo~gage s, or Other Seeu,%es ff none, check here. DNone

Instructions

is~ueofthispubli¢~tion

78.83 [:3 Checkboxffnmrequiredtopub]~sh.

.

Date

dmt

y~

hi

h

H

I

,

a

to Publishers

1. Complete and file one copy of this form with your p ~ f m a s i e r on or before October 1. annually Keep a copy ot the ~empleted form for

your records.

~/A

2 Include in items 10 and 11, in ~a~es where the stockholder or securlty hol~er is a trustee, the name of lhe person or corporation for whom the tmslee is aotlng. Ais0 Mclude the names and addresses of ]ndMdua[s who are stockholders who own or hold 1 percent or more of the total amount of bond~, mortgages, or other s~uritles of the publishing corporatlon In ~lem 11. if none. check b~x. Use blank sheels if more space is required 3 ge su[e Io furnish all info~at[on called for in item 15. regardMg circulation. Free c#cu[atien musl be shown in item8 15d. e. a n d f '4. I1the publication bad second-class authorization as a general or l equester publloat]cn, th~s £1atement of Ownership, ManagemenL and Circulation must be published; ]1 must be prinle6 in any issue in October or the iitst pdnled issue after October ]1 the publication is not DubIished d u r n g October 12. For completion by n~praf~t or~ani~liO~S authorized la mall at apecia[ rates Tee purpose, funclion, and neap refit s~atusel this organi~ticn and the exempt $~1~ t~r fede~l i~come tax purposes: (Cheep on~) ~ H~$ N~t Chan~ed ~uring pcecedM~ 12 Months Has Change~ Ounng Preceding 12 Months ps F o ~ 3 5 2 6 , OCtober 1994

5 In ]lem 16, indicale dat e of lhe issue in which thls Statement of Ownershlp w~l be printed 6 Item 17 must be signed

Feature~ofge or pu##sh a statement of ownersh# may lead to suspeamon of second.class author,zebra°.

(SeeInfractions on Rewrse)

Special Inlroductory Offer

E,,oludono f R ~ e $ } ~ : A C~parlson belwe~l Cologne and C l ~ e ] ~ d

N o w y o u c a n s u b s c r i b e to

.

=

=

Prehospital and Disaster Medicine your passport to the international world of EMS expertise--for only $35. Each important issue brings you: A scientific review of the most recent emergency response to disasters and MCIs around the globe • •

The most up-to-date summaries (and criticism) of the worldwide practice of emergency medicine

....... Lo~PrielaEarthquake

'iC~'iF,.a£~ 7:7,:i ii:ilif,7 '?,::,'Z: ,:::%':J::'17: ;.:,"~:,~i!)](:f:',:;l~i:~);:) "

:i':~:7o7~7:~'=~f~i7,(~ " ~2;}:,:~ti77#:-iiI,.::I?,.,GTZ: '[77~775'?:?,W~:: 91i~:])~;~7

~77"6~i =::'-:;' ?::F!:h'÷~)9~i!

p=:':a,:,~ ::6:;%!:,2:i!!' .........

Concise analysis of how emergency services operate around the world--and ways you can learn from them 'E<~g::iC~'i!........

Air Medical Journal

13:11-12

November/December 1994

493