- Email: [email protected]
Setting Standards
Ask the CAMTS
Eileen Frazer, RN, CMTE
Setting Standards The current Commission on Accreditation for Medical Transport Systems (CAMTS) Accreditation Standards 7th Edition, published in 2006 and supplemented with an addendum in January 2009, will be replaced by the 8th Edition in 2010. Standards are dynamic in any professional field, but in medical transport, “motions produced by given forces,” Webster’s definition of dynamic, is especially pertinent. Rotor-wing services, in particular, have been under the spotlight most recently, and changes are in process by the Federal Aviation Administration (FAA) and the National Transportation Safety Board (NTSB) that may result in the way business is conducted. As regulations and public scrutiny force change, voluntary standards must set the tone for a higher level of service but also recognize the uniqueness of each air and ground medical transport company. As we contemplate the changes for 2010, we also make sure the standards are in sync with our values and with our expectations of accredited services, as follows:
CAMTS Values • • • • •
Fair Ethical Consistent Accountable Patient and safety focused
Transport Organization Expectations • • • • •
Honest self-assessment Ethical business practices Patient and safety focused Continuous quality improvement Transparency in the accreditation process
One of the goals of the 2010 8th Edition will be to completely reformat and reorganize the standards so that each topic will have measurable criteria that provide examples of evidence. The Standards Committee believed that examples of how to comply with a specific standard will assist our constituents in interpreting its intent. It also has been suggested that each standard should be supported by scientifically based research as evidence. In the 8th Edition, we will provide research references for as many standards as possible. However, we know that there is precious little research-backed practice in the medical transport field. Most of our standards are time tested, meaning they have been out there for quite awhile. Many have changed, and some past standards have been deleted based on current practice. Some standards are based on issues we see as we review programs and others on current affairs. For example, after the 9/11 206
terrorist attack on the World Trade Center, we began to require that programs develop a policy for checking carry-on baggage for hazardous materials. We also updated the criteria regarding aircraft security standards. The CAMTS board also reviews air medical accidents; after the flurry of fatal accidents in the summer of 2008, we developed an addendum to the 7th Edition that will be refined and included in the 8th Edition. The board believed that these issues were so important that we did not want to wait until the next edition was published. The addendum specifically targets fatigue and sleep deprivation, helipad communications, and crew coordination issues, among other hot topics. The addendum went through six drafts—all posted on the web site—and was approved in January 2009 in its final version as currently found on our web site. When we draft new standards, they are sent to all our member organizations for distribution to their constituents. In addition, we welcome comments from individuals and groups. Drafts are posted on the web site, and comments are sent directly to the CAMTS office. Each draft is distributed to the CAMTS Standards Committee until one is ready for review by the board of directors. Drafts are reviewed by the board until a final draft is approved through a majority vote. Aviation standards and changes to standards that affect pilots, technicians, or aviation management are also sent to the NTSB and the FAA for their comments and suggestions. Another change that the Standards Committee will be working on is to develop a complete body of standards for each transport mode: rotor-wing, fixed-wing, and ground. We will have a method to address the redundancies in the program information form for those services that provide more than one transport mode, but a complete set of standards for each transport mode will lessen the confusion about applicable and nonapplicable standards. The CAMTS Standards Committee welcomes participation from medical transport professionals of all disciplines. We meet formally once a year during the Air Medical Transport Conference, so watch for an announcement about the meeting, which is open to all attendees. If you are specifically interested in participating on the committee, please contact the CAMTS office, and we will add you to our email list to receive communications and drafts from our chair, Laura Lee Demmons. Eileen Frazer, RN, CMTE, is the executive director of the Commission on Accreditation of Medical Transport Systems. She can be reached at [email protected] or (864) 287-4177. 1067-991X/$36.00 Copyright 2009 by Air Medical Journal Associates doi:10.1016/j.amj.2009.06.014 Air Medical Journal 28:5
Eileen Frazer, RN, CMTE
Setting Standards The current Commission on Accreditation for Medical Transport Systems (CAMTS) Accreditation Standards 7th Edition, published in 2006 and supplemented with an addendum in January 2009, will be replaced by the 8th Edition in 2010. Standards are dynamic in any professional field, but in medical transport, “motions produced by given forces,” Webster’s definition of dynamic, is especially pertinent. Rotor-wing services, in particular, have been under the spotlight most recently, and changes are in process by the Federal Aviation Administration (FAA) and the National Transportation Safety Board (NTSB) that may result in the way business is conducted. As regulations and public scrutiny force change, voluntary standards must set the tone for a higher level of service but also recognize the uniqueness of each air and ground medical transport company. As we contemplate the changes for 2010, we also make sure the standards are in sync with our values and with our expectations of accredited services, as follows:
CAMTS Values • • • • •
Fair Ethical Consistent Accountable Patient and safety focused
Transport Organization Expectations • • • • •
Honest self-assessment Ethical business practices Patient and safety focused Continuous quality improvement Transparency in the accreditation process
One of the goals of the 2010 8th Edition will be to completely reformat and reorganize the standards so that each topic will have measurable criteria that provide examples of evidence. The Standards Committee believed that examples of how to comply with a specific standard will assist our constituents in interpreting its intent. It also has been suggested that each standard should be supported by scientifically based research as evidence. In the 8th Edition, we will provide research references for as many standards as possible. However, we know that there is precious little research-backed practice in the medical transport field. Most of our standards are time tested, meaning they have been out there for quite awhile. Many have changed, and some past standards have been deleted based on current practice. Some standards are based on issues we see as we review programs and others on current affairs. For example, after the 9/11 206
terrorist attack on the World Trade Center, we began to require that programs develop a policy for checking carry-on baggage for hazardous materials. We also updated the criteria regarding aircraft security standards. The CAMTS board also reviews air medical accidents; after the flurry of fatal accidents in the summer of 2008, we developed an addendum to the 7th Edition that will be refined and included in the 8th Edition. The board believed that these issues were so important that we did not want to wait until the next edition was published. The addendum specifically targets fatigue and sleep deprivation, helipad communications, and crew coordination issues, among other hot topics. The addendum went through six drafts—all posted on the web site—and was approved in January 2009 in its final version as currently found on our web site. When we draft new standards, they are sent to all our member organizations for distribution to their constituents. In addition, we welcome comments from individuals and groups. Drafts are posted on the web site, and comments are sent directly to the CAMTS office. Each draft is distributed to the CAMTS Standards Committee until one is ready for review by the board of directors. Drafts are reviewed by the board until a final draft is approved through a majority vote. Aviation standards and changes to standards that affect pilots, technicians, or aviation management are also sent to the NTSB and the FAA for their comments and suggestions. Another change that the Standards Committee will be working on is to develop a complete body of standards for each transport mode: rotor-wing, fixed-wing, and ground. We will have a method to address the redundancies in the program information form for those services that provide more than one transport mode, but a complete set of standards for each transport mode will lessen the confusion about applicable and nonapplicable standards. The CAMTS Standards Committee welcomes participation from medical transport professionals of all disciplines. We meet formally once a year during the Air Medical Transport Conference, so watch for an announcement about the meeting, which is open to all attendees. If you are specifically interested in participating on the committee, please contact the CAMTS office, and we will add you to our email list to receive communications and drafts from our chair, Laura Lee Demmons. Eileen Frazer, RN, CMTE, is the executive director of the Commission on Accreditation of Medical Transport Systems. She can be reached at [email protected] or (864) 287-4177. 1067-991X/$36.00 Copyright 2009 by Air Medical Journal Associates doi:10.1016/j.amj.2009.06.014 Air Medical Journal 28:5