Air ambulance accreditation in the era of Covid-19

Site surveyors

Of the 60 active site surveyors, 50 per cent are employed in medical transports services, having responsibilities for direct patient care, and we did not schedule these healthcare providers for on-site visits. They were also, and still are, limited by their own employers. Understandably, travel was banned by full-time employers for many site surveyors.

There are also a few senior site surveyors and those compromised by their own healthcare issues. We are grateful to those who were able to travel and complete some of the visits as we navigated and adapted to the whims of the coronavirus spread throughout the year. Fortunately, none of our surveyors contacted Covid-19 while travelling for CAMTS.

Restoring the human connection

Medical transport services have unique opportunities to address the challenges of transporting patients while keeping staff healthy and able to function with diminishing resources and higher needs. Accredited services have met these challenges with new processes that were never anticipated. We share the many resources our accredited services developed, from educational videos to practices. Few serious illnesses among the crews who care for suspected and known Covid-19 patients have been reported.

We all look forward to getting back to ‘normal’. Virtual meetings and surveys are a necessary substitute, but not the same as meeting and greeting our constituents, peers, friends, and families in person. We anticipate a brighter year in 2021 and hope to see you in Madrid next fall.

EURAMI

Claudia Schmeidhuber, Managing Director of the European Aero-Medical Institute (EURAMI,) offered an update into how the organisation had coped with everything 2020 had to throw at it, and how it is using its digital prowess to ensure standards don’t slip

2020 was an unprecedented year – not only for the European Aero-Medical Institute – but for the whole aeromedical industry and the world. Faced with unprecedented challenges – travel restrictions, lockdowns and no planes in the air – EURAMI had to re-invent itself in an innovative and state-of-the-art fashion

Alternative audit arrangements

The biggest challenge that all accreditation companies have been facing is the restriction of travel and the health and safety concerns for dedicated volunteers, which make it impossible for EURAMI auditors to travel on-site to providers. As it became clear the pandemic crisis would be a prolonged event, the Board agreed they could not put off the growing number of reaccreditations indefinitely. In an effort to reduce this backlog and to provide a suitable solution, the EURAMI leadership developed an alternative auditing method – the EURAMI Virtual Audit. It was introduced by Dr Cai Glushak, President of EURAMI, along with Claudia Schmiedhuber, Managing Director, at the 35th Annual EURAMI General Assembly, which was held virtually with more than 70 participants for the very first time in the history of the association.

Since the General Assembly in November, EURAMI has continued to digitalise its processes and should have all procedures fully virtual by the end of Q2 this year. In addition, EURAMI has been working on designing a fully digitalised scoring and reporting tool to standardise its audit processes, and documentation aligned with the virtual audit, which will be launched in March.

Increased uptake in accreditation

Another positive ‘challenge’ EURAMI is currently facing is the increased number of applications that we have received in the last two years. EURAMI has thus installed a waiting list for providers until they can start the process for their desired accreditation. Whilst this is a great sign that EURAMI accreditation is gaining widespread respect and recognition, the pandemic makes it difficult to maintain the pace of audits for qualified providers. Notwithstanding this challenge, the EURAMI Board unanimously decided that primary accreditation must be done in person to ensure that every aspect of the air medical transport programme is examined in detail for the first time. Although the situation changes daily, EURAMI expects on-site primary accreditation to be re-started in Q2 of 2021, and we look forward to recognising those new providers who demonstrate their commitment to safety and quality in aeromedical services.

Covid transport data lacking

EURAMI is privileged to have a richly diverse and supportive membership that derives from the utmost experts in their field. One thing that became clear in the first months of the pandemic was the dearth of data available on safety and number of transports of Covid-19 patients. EURAMI has thus created membership surveys that are obtaining such data anonymously. The first survey was done in August, and had a good response rate from the membership. Questions included topics such as change in business/missions since March 2020, total missions flown, total Covid-positive patients flown, number of patients transported in isolation units, and impact on infection rate of staff after Covid missions. EURAMI is currently conducting a second round of its survey and will be publishing the article amongst the membership in due course.

The European Aero-Medical Institute will continue its effort to not only support members more efficiently during these challenging times, but also progressing to a EURAMI 2.0. with a focus on continuing advancement.

NAAMTA GLOBAL

Roylen Griffin discusses the National Accreditation Alliance of Medical Transport Applications’ (NAAMTA) ongoing focus on quality patient care and the integration of risk management processes in the air medical transport sector

We wish to give a heartful thanks and a debt of gratitude to the amazing men and women of science and medicine that have worked diligently to combat Covid-19 and to care for the critically ill and terminal patients. We sorrow with those who have lost family, friends, and coworkers, and stand in awe at the level of dedication demonstrated throughout these challenging times.

NAAMTA Global accreditation for our medical transport and medical escort providers focuses on quality patient care and the integration of safety and risk management systems for the patient, family members and service providers. We accomplish this through our ongoing quality management and continuous compliance and commitment processes.

Continuous accreditation compliance and commitment

NAAMTA Global Alliance members participate in the Continuous Compliance and Commitment Programme (CCCP). Each accredited programme provides quarterly reporting, which identifies continuous compliance with accreditation criteria. Patients, family members, hospitals, clinics, insurers, and assistance programmes correlate confidence in services that demonstrate this ongoing measurement of excellence. The reports provide insight into the challenges our customers face. They identify trends and help us to generate a general summary, which then helps programmes overcome hurdles. Examples include:

• PPE shortages – were quickly identified with US Centers for Disease Control & Prevention (CDC)-approved alternative recommendations
• Companies identified strategies for skills maintenance, license, and certificate renewals
• Using web-based online meeting tools, NAAMTA was able to have more face-to-face contact with our accredited members and our applicant members to assist in the accreditation process
• Programmes took advantage of down times to refine policies
• Medical escort operations came to a near standstill and continue to struggle with travel restrictions.

As we all became familiar with working from home, new techniques evolved.

NAAMTA Global safety app

The NAAMTA Global Safety App became an avenue for the National Institute of Occupational Safety and Health (NIOSH) and the CDC to provide healthcare workers and NAAMTA Alliance members information and training on working with infectious disease. Furthermore, based on information collected, it offered NIOSH and the CDC the ability to accumulate real-time concerns for these workers, driving additional training and micro-learning modules to our users.

NAAMTA Self-Assessment and Application Tool (NEAT)

NAAMTA has always seen the NAAMTA Standards as a self-assessment and accreditation tool, but the process of working between the Standards and the NAAMTA Application is now improved to enable an applicant to identify their progress throughout the accreditation process.

Beta tested in 2020, the NEAT introduces the following features:

• Dashboard interface with charts and graphs identifying progression, completion, and focus areas
• Self-assessment tool to identify policies and procedures that meet the standards or need to be revised to be compliant with the standards
• Reduction of documentation
• Streamline processes are inherent in the NEAT by using specific references to standard criteria,
• Internally, applicants can quickly identify the required response to each standard
• Externally, the precise responses provided enable the NAAMTA Auditors the ability to assess compliance to each standard.
• Single-source reporting is integrated within the NEAT to monitor the completion of each phase of the accreditation from the administrative (documentation audit), site audit, corrective action items, and closure.

Our end of the year QMS meeting is when we look back to assess our yearly goals and establish goals for the new year. We are currently working with several new and renewing accreditation applicants in 2021.

We are excited about the synergy in the medical transport industry. The pursuit of accreditation for quality improvement, industry recognition, meeting customer expectations, and building an industry alliance, aligns with our initial desire of providing a service to our customers who are diligent in serving their patients.