Education, safety, and quality management
Article Outline
Some of the most extensive accreditation standards published by the Commission on Accreditation of Medical Transport Systems (CAMTS) address medical personnel initial and continuing education and quality management (QM), which includes safety programs. Compliance with these standards is also the most difficult to evaluate because there are many ways to have effective education, QM, and safety programs. Accessing the effectiveness of these programs is not black and white, as is the standard that requires “no smoking” signs on the aircraft, for example.
These are also the standards that traditionally lead to the most cited concerns and deficiencies. We often find that compliance with initial and ongoing education requirements is perhaps taking place but is not well documented. The safety committee may meet, but scanty minutes often suggest that the committee is not effective in identifying and resolving issues through action plans and follow-up reports.
Circle the number that best describes the education program at the time of your site visit.
| 1 | Program planned but not implemented. |
| 2 | Education plan implemented, but most of the staff has not completed required currencies and competencies. |
| 3 | Education program is developed and most of the staff has completed required currencies and competencies, but documentation is weak. |
| 4 | Education program is developed and mature, with only a few required competencies outdated. |
| 5 | Education program is mature, and all required competencies are current and plans for ongoing education evident. |
Circle the number that best describes the safety program at the time of your site visit.
| 1 | Safety program planned but not implemented. |
| 2 | Safety program is implemented but not mature. Meeting minutes do not reflect action plans, and no follow-up is evident. Staff is not aware of safety program activities. |
| 3 | Safety program is developed but may be fragmented; pilots, communicators, and medical personnel may meet separately. Most of the staff understands how to report a safety concern, but feedback is not consistent. |
| 4 | Safety program is mature and integrated, with all disciplines participating and knowledgeable of safety program activities, but safety is not linked to the QM program and there is no clear risk assessment analysis for aviation, operations, patient care, or any combination of these areas. |
| 5 | Safety program is mature with a link to QM for risk assessment and loop closure. There are examples of reporting safety issues (both operational and patient care related) until problem resolution occurs. A safety culture is evident that allows for nonpunitive reporting. |
QM is difficult for many air medical services. We often find that criteria have been identified, but loop closure is not always evident. In addition, most air medical services are knowledgeable about medical QM, but operational and communications criteria are limited to response time issues.
To assist site surveyors and board reviewers, CAMTS recently developed gap analysis charts to access the effectiveness of each of these programs as follows:
The CAMTS board also approved the development of a publication, Quality Management for Medical Transport, to assist programs in developing and designing effective QM. Flight Safety is assisting CAMTS in the development and production costs of this publication, which will be available in various formats in early 2007. There has not been a publication regarding QM for air medical transport since 1988. Please watch the CAMTS website (www.camts.org) for announcements about the QM publication.
Circle the number that best describes the quality management program at the time of your site visit.
| 1 | QM planned but not implemented. |
| 2 | QM is implemented but not mature. Meeting minutes do not reflect action plans, and no follow-up is evident. Staff is not aware of QM activities. |
| 3 | QM is developed but is predominantly focused on medical criteria. Most of the staff understands the QM process, but feedback is not consistent. |
| 4 | QM is mature and integrated, with all disciplines participating and knowledgeable of QM activities, but there is no clear link to safety and risk management. |
| 5 | QM is mature and integrated, with examples of reporting aviation, operational, and adverse medical events until problem resolution occurs. Staff is fully involved and understands the process. |
PII: S1067-991X(06)00159-3
doi:10.1016/j.amj.2006.06.002
© 2006 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.