Nothing is more important than the safety of our crew and patients. We maintain a culture of safety that involves every aspect of the organization and every single staff member.
Our commitment to safety is led by a safety-management committee comprised of representatives from each Boston MedFlight department. This committee ensures aviation, occupational, environmental and emergency management safety through education, identification of potential hazards, investigation and analysis of safety-related events.
Employees are encouraged to take an active role in overall safety management by discussing, evaluating and reporting situations that may contribute to an unsafe working environment, along with diligence in following standardized policies and procedures.
Safety communication is an integral component of Boston MedFlight’s safety culture. Best practices and protocols include the following.
Shift Briefing: At the start of every shift the entire crew comes together and completes a defined, step-by-step, safety briefing.
Daily Snapshot: Once a day, all on-duty pilots, communications specialists, the aviation administrator on call, director of maintenance, and any other administrators on call discuss system status, weather, other NEAA program status, and aircraft maintenance.
Debriefing: The entire crew plus the communication specialist identify and review any potential hazards, or safety issues that occurred, after every transport.
Safety Summary: A monthly report is generated that includes all reported safety incidents (hazards, near-miss and actual); status of current safety projects and audits; safety facility and vehicle updates; emergency management updates; and all other safety related information.
MedFlight Information Sharing System (MISS): this is a system developed by BMF to rapidly report safety concerns to a responsible member of management to address the issue immediately. The system is designed to require a rapid response to the employee filing the report, or the report is raised to the next higher person in the organizational ladder until it is addressed. The MISS also provides a tool for safety data tracking and analysis.
Internal Alert Notification (IAN): This is an electronic system that is used to notify all staff members, through a defined process, of any occurrence that compromises or has a high likelihood to compromise patient or team safety. This notification process is solely intended to disseminate information in a timely manner.
Safety Alerts: This mechanism shares pertinent written safety reports with all employees and has the potential to impact another crew until issues are fully addressed. Examples may include landing zone issues, mechanical events during movement, facility safety issues, etc. A standardized email template is used to communicate the safety alert.
Notices to Airmen (NOTAM): This system lets the Helicopter Air Ambulance Services (HAA) programs in the North East Air Alliance (NEAA) electronically share any helipad, landing zone or related hazards between communication centers and pilots.
Event Sharing: This is a mechanism by which we regularly share safety events at NEAA and partner hospitals’ quality and safety meetings/case reviews.
CONCERN Network: This network provides information regarding accidents and incidents in the air medical and critical care transport community. Boston MedFlight subscribes to bulletins and also voluntarily submits information on any accident or incident to the network. The purpose of the CONCERN Network is to increase awareness of safety hazards in the medical transport community.
Boston MedFlight pilots are designated by the FAA as Airline Transport Pilot — the highest commercial pilot designation. Training is a continuum of computer testing modules, classroom instruction, periodic flight evaluations with designated check pilots and annual flight simulation training.
Pilots are proficient in both Visual Flight Rules (VFR) and Instrument Flight Rules (IFR). Once a transport is requested, communication specialists review the request and the information is transmitted to the appropriate pilot. If the Pilot-in-Command accepts the flight, he/she dispatches the medical crew. At no time prior to a Pilot-in-Command accepting or rejecting a mission is patient’s condition provided to the pilot. This "blind acceptance" assures no undo pressure is placed on a pilot to accept a flight under questionable conditions.
A weather-reporting system is located at each base and in our Communication Center. Decisions to accept or decline missions are made based on forecasts, visibility, distance, terrain hazards, ceiling and runway conditions.
Crew Resource Management Training:
Crew Resource Management (CRM) annual training is required for all Boston MedFlight clinical, communication, and operation management staff, plus all contracted aviation and maintenance staff.
CRM encompasses a wide range of knowledge, skills and attitudes including communication, situational awareness, problem solving, decision making, and teamwork, together with all the sub-disciplines that each of these areas entails. CRM can be defined as a management system that makes optimum use of all available resources—equipment, procedures and people—to promote safety and enhance the efficiency of flight operations.
CRM is concerned not so much with the technical knowledge and skills required to operate a vehicle or deliver clinical care but rather with the cognitive and interpersonal skills needed to manage a transport within an organized critical care transport system. In this context, cognitive skills are defined as the mental processes used for gaining and maintaining situational awareness, for solving problems and for making decisions. Interpersonal skills are regarded as communications and a range of behavioral activities associated with teamwork.
Maintaining a Safe Fleet:
Seven full-time Boston MedFlight rotor-wing aviation technicians are on call seven days a week, 24 hours a day to ensure equipment and vehicle safety for our rotor-wing aircraft.
Each mechanic maintains Federal Aviation Association (FAA) Airframe and Power plant (A&P) licensure. In addition, each mechanic attends factory-training courses specific to each type of airframe and recurrent training in specific areas such as avionics and composite materials repair. Maintenance on each aircraft is completed by A&P technicians in accordance with manufacturer guidelines under guidance of our Director of Maintenance.
Aircraft inspections are performed daily including, the Pilot-in-Command performing a “preflight” inspection. This includes visual inspection of internal/external aircraft components in accordance with manufacturer and vendor guidelines.
Our ground critical care units are safety inspected daily by our EMT-Operator staff. In addition, both routine and unscheduled maintenance are performed at contracted chassis and ambulance manufacturer repair stations.