As an EMS program manager, you are responsible for running a helicopter transport business. The purpose of your business is to put living patients in need of critical care in hospital beds as efficiently as possible without anyone's getting hurt or creating any bad press for the hospital. This challenge is formidable.
Part of this challenge involves deciding when and how to change your business to make it more effective. As a first step in this process, you have just completed a detailed profile of your business as it looked during the past few years. Your next step is to write a new profile that describes what you want your business to look like in 5 or even 10 years in the future. This future profile will serve as the foundation for your near-term purchasing plans. These plans will include aircraft but also may include investments in such things as hangars, helidecks, refueling facilities, or dispatch facilities.
Because the future profile looks at all aspects of your business, it should be created by a committee that includes expert representatives from all of the areas affecting your business. This group should include pilots, maintenance personnel, members of your financial and legal offices, and representatives of your medical community. Depending on whether your operation is hospital-owned or works under contract, these people may or may not work for your boss. Regardless, building a consensus as to the future shape of your business requires everyone's input.
This committee should seek to answer several critical questions:
What types of missions will you be flying?
This is really two questions—medical and operational. Although based on your current profile, the answer to this question will be linked to changes in demographics, territory, capability, and your hospital's priorities. Will new medical technologies allow you to fly new types of missions? On the operational side, if you are now a VFR operation, can you be more effective or safer by operating IFR? Will you be able to fly more missions if you install GPS approaches? If you are limited by icing conditions, is certified deicing capability important?
Can you bring in additional business by going farther?
Is your business hemmed in by geography or other operators? Does the new territory have enough business to make it worth your going there? Can your home hospital form alliances with outlying hospitals that will allow the helicopter to bring in additional business?
What equipment should be installed in a new helicopter?
Again, this involves both technical and medical issues. The answers are going to be closely linked to what types of missions you intend to fly and the new technology becoming available. Will you need the capability to perform nonprecision IFR approaches? How about the new nonprecision with vertical guidance criteria that the FAA is considering? The most difficult part of this question is determining what new equipment will be available and certified for use on aircraft in the time frame that you will need it.
Under what performance or atmospheric limitations will the helicopter have to operate?
The answers should include altitude, temperature, and takeoff criteria. The historical profile should be adjusted by including the effects of the new territory from the second set of questions above. It also should include changes brought about by new landing sites and the ratio of scene versus hospital takeoffs.
How will all of the above affect the number of transports you do in a year?
This is the real crux of the exercise. Remember, the purpose of your business is to safely put patients in beds. Before you go before your boss, you are going to need a justification for spending money. The most effective explanation is that it will bring in more business. Conversely, if the answers to the first 4 questions don't result in a significant increase in patient transfers, perhaps changing your operation is not justified. A perfectly legitimate outcome of this study is that you should be focusing on making your operations safer and more efficient rather than different.
The result of this thoughtful study should be a document that describes what the committee believes your operation should look like in the foreseeable future. In the most general terms possible, it should describe the aircraft, the types of operational and medical equipment it needs to carry, and where and how it will be flown. It also should provide a reasonable estimate of how many helicopters will be required, how many hours they will fly in a year, how many takeoffs and landings per hour, and the spectrum of both scene and interhospital flights.
So why go to all this work? The first purpose of the future profile is to demonstrate to the hospital or operator's managers (your bosses) that you have analyzed your needs and can justify a change that will improve your operation. It increases your credibility and helps keep you from making expensive mistakes.
After your management has approved your change, the profile will serve as the foundation for a request for proposal that you will create and send out to the manufacturers or the vendors, if you are purchasing a service.
In addition, the profile should allow you to move forward with a minimum of confusion and dissension because each of the groups that can influence your progress already have contributed to the profile.
In the next article, we will discuss converting the profile to the technical requirements portion of an RFP.
Note: This column is written in an attempt to increase the understanding of medical personnel who work around helicopters and their pilots. I cannot do this alone: I need your comments both to help me understand how well I am communicating and to find subjects that are interesting and helpful to you. I can be reached at vaskue@sikorsky.com or by phone at (203) 386-6451.
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