- Email: [email protected]
Keeping It Simple
Safety Matters
Ed MacDonald
Keeping It Simple There have been rumors of regulations, rumors of congressional action, fury in the press, and lots of chatter. The latest rumored timetable of the alleged Federal Aviation Administration (FAA) Notice of Proposed Rule Making is now July 2010. This proposed set of regulations will purportedly address and make regulations of many of the past Advisory Circulars and National Transportation Safety Board recommendations that Congress and others have been pushing. It is not as though we as helicopter emergency medical services or fixed-wing and ground services do not know how to do the right things by now; it just takes a will (and financial commitment), not simply a regulation. If the FAA needs to make rules and Congress needs to act, so be it. We know what to do to be safe. The air medical community has been moving forward to police itself and make our task safer for years now. Here is the short version: Hire and train competent well-qualified pilots and flight crews who can and will practice sound decision-making and incorporate their actions conservatively in an air medical resource management–based team. Pilots (and crews) who are hired should not be white knights and risk takers by avocation. Managers, pilots, mechanics, communications specialists, and clinical staff should respect each other and communicate as though their lives depend on it— mostly and simply because they do. Ensure crews are healthy and well rested, and monitor fatigue risk closely. Continue to train and maintain the highest standards. Provide the pilot and crews with the right equipment and gadgets to get the job done. This means choosing an aircraft that will perform under all of the conditions it will be asked to work under—from high and hot or night or instrument. The appropriate aircraft decision should be made first by the aviation professionals, with adequate consideration for the clinician’s needs. Clinicians must have the right tools for the job as well. Ensure that the aircraft has the right stuff for the mission. This entails full instrument capability (to include global positioning system routes or approaches) if the weather is often marginal and night vision capability if the service flies in the dark. The aircraft should have plenty of power and tail rotor authority if it needs to be in high places. Help the pilots maintain situational awareness through devices such as helicopter terrain awareness systems. Implement a systems approach to safety through safety management systems (SMS), no matter how small the organization is. SMS treats safety in a structured manner and emphasizes safety every bit as strongly as other business functions. Safety should never take second place. Be 148
ever vigilant for risks that can develop in a heartbeat, and take action or address every concern in a timely manner. Listen to concerns as though the crews’ lives depend on management’s timely attention, because they do. Safety should always trump competing business or marketing— one accident will destroy the latter. Managers must choose their inspiring business motivational speeches with discretion so that one errant phrase is not misinterpreted as pressure to fly when good sense says stay home. Meet regularly with competitors, and do not compete with a few minutes of response time or weather shopping. Educate hospitals and prehospital personnel regularly to ensure that they are aware of our risks and understand how our safety applies to them as well. Managers must not be the problem. Train our mangers to be leaders and listeners. Exercise a structured and effective enhanced operational control system by infusing conservative operational control into a line pilot’s decision making. Develop and aggressively use a risk management matrix with direct ties to the operator’s operational control managers. Back these systems up with satellite flight following, and monitor the aircraft and crews with some form of cockpit or voice recording so that errors or errant behaviors can be caught before they become bigger problems. The air medical community has taken giant leaps toward improving our chances at coming home safely after every flight; however, as is apparent from a few recent accidents, there are some programs, pilots, and crews who just do not get it. Most of us in the professional organizations, enlightened programs, and conservative operators have been pushing safety as the priority through those risk mitigations highlighted in this article for years. Apparently, it might just take more rules to get to the few who keep missing the point. It is all about coming home at the end of our shift. Ed MacDonald is lead pilot for PHI Air Medical in Santa Fe, NM, Co-chairman of the AAM/CORE Safety Committee, Chairman of the Air Medical Safety Advisory Council, and safety representative for the National EMS Pilots Associations. He can be reached at [email protected]. 1067-991X/$36.00 Copyright 2010 Air Medical Journal Associates doi:10.1016/j.amj.2010.04.010
Air Medical Journal 29:4
Ed MacDonald
Keeping It Simple There have been rumors of regulations, rumors of congressional action, fury in the press, and lots of chatter. The latest rumored timetable of the alleged Federal Aviation Administration (FAA) Notice of Proposed Rule Making is now July 2010. This proposed set of regulations will purportedly address and make regulations of many of the past Advisory Circulars and National Transportation Safety Board recommendations that Congress and others have been pushing. It is not as though we as helicopter emergency medical services or fixed-wing and ground services do not know how to do the right things by now; it just takes a will (and financial commitment), not simply a regulation. If the FAA needs to make rules and Congress needs to act, so be it. We know what to do to be safe. The air medical community has been moving forward to police itself and make our task safer for years now. Here is the short version: Hire and train competent well-qualified pilots and flight crews who can and will practice sound decision-making and incorporate their actions conservatively in an air medical resource management–based team. Pilots (and crews) who are hired should not be white knights and risk takers by avocation. Managers, pilots, mechanics, communications specialists, and clinical staff should respect each other and communicate as though their lives depend on it— mostly and simply because they do. Ensure crews are healthy and well rested, and monitor fatigue risk closely. Continue to train and maintain the highest standards. Provide the pilot and crews with the right equipment and gadgets to get the job done. This means choosing an aircraft that will perform under all of the conditions it will be asked to work under—from high and hot or night or instrument. The appropriate aircraft decision should be made first by the aviation professionals, with adequate consideration for the clinician’s needs. Clinicians must have the right tools for the job as well. Ensure that the aircraft has the right stuff for the mission. This entails full instrument capability (to include global positioning system routes or approaches) if the weather is often marginal and night vision capability if the service flies in the dark. The aircraft should have plenty of power and tail rotor authority if it needs to be in high places. Help the pilots maintain situational awareness through devices such as helicopter terrain awareness systems. Implement a systems approach to safety through safety management systems (SMS), no matter how small the organization is. SMS treats safety in a structured manner and emphasizes safety every bit as strongly as other business functions. Safety should never take second place. Be 148
ever vigilant for risks that can develop in a heartbeat, and take action or address every concern in a timely manner. Listen to concerns as though the crews’ lives depend on management’s timely attention, because they do. Safety should always trump competing business or marketing— one accident will destroy the latter. Managers must choose their inspiring business motivational speeches with discretion so that one errant phrase is not misinterpreted as pressure to fly when good sense says stay home. Meet regularly with competitors, and do not compete with a few minutes of response time or weather shopping. Educate hospitals and prehospital personnel regularly to ensure that they are aware of our risks and understand how our safety applies to them as well. Managers must not be the problem. Train our mangers to be leaders and listeners. Exercise a structured and effective enhanced operational control system by infusing conservative operational control into a line pilot’s decision making. Develop and aggressively use a risk management matrix with direct ties to the operator’s operational control managers. Back these systems up with satellite flight following, and monitor the aircraft and crews with some form of cockpit or voice recording so that errors or errant behaviors can be caught before they become bigger problems. The air medical community has taken giant leaps toward improving our chances at coming home safely after every flight; however, as is apparent from a few recent accidents, there are some programs, pilots, and crews who just do not get it. Most of us in the professional organizations, enlightened programs, and conservative operators have been pushing safety as the priority through those risk mitigations highlighted in this article for years. Apparently, it might just take more rules to get to the few who keep missing the point. It is all about coming home at the end of our shift. Ed MacDonald is lead pilot for PHI Air Medical in Santa Fe, NM, Co-chairman of the AAM/CORE Safety Committee, Chairman of the Air Medical Safety Advisory Council, and safety representative for the National EMS Pilots Associations. He can be reached at [email protected]. 1067-991X/$36.00 Copyright 2010 Air Medical Journal Associates doi:10.1016/j.amj.2010.04.010
Air Medical Journal 29:4