First of all, let’s introduce the company – Jet Rescue. Its air ambulance fleet is comprised of 10 medical jets and one helicopter, including a Falcon 50, a Learjet 60, a Learjet 36, five Learjet 35s and two Learjet 55s. These air ambulance jets are capable of short range, as well as long range and international flights. Each plane is custom configured to transport adult, paediatric and neonatal patients, and can be configured to transport dual stretcher patients if needed. The fleet is licensed and insured in the US and Mexico, and is able to obtain international permits for countries that may be more challenging, such as Panama. All flights are performed with a critical care physician and paramedic onboard, and tools in the medical team’s arsenal include ultrasound and portable lab.
Carlos Salinas is President and CEO of the company, but unlike some other CEOs, he remains very hands-on with the day-to-day operations. Although there’s no such thing as a ‘typical day’ for him, he told ITIJ that he will normally spend time in each different department early in the morning to ensure mission readiness. The entire team, he explained, works together to ensure all the different parts of the puzzle come together. “Flight ops change shift, updating the new shift on all ongoing missions, pending missions, quotes, aircraft status and location and so on. The medical department checks their equipment and supplies, pilots on call report to the office and in conjunction with the maintenance department, get assigned to a specific aircraft.” Operating an air ambulance business, he said, is a complex and challenging task involving both medical and aviation professionals. “If one aspect fails, the mission will fail.” Without the professional commitment of individuals throughout the air ambulance commissioning process, there remains the potential for mistakes.
A particular set of skills
What about the type of person it takes to work in the international fixed-wing air ambulance industry? Salinas told ITIJ: “It does take a very special breed of people to work in this business. We look for people that enjoy serving others, are self-motivated, and in the case of medical staff and pilots, they have to be the type of people that enjoy adventures.”
When it comes to adventures, there are few regions in the world that have more adventures to offer than Central and South America, which is why employees of Jet Rescue need to be able to embrace that particular challenge! Some countries are trickier to work in than others, though, as Salinas explained: “We don’t like to fly to Cuba and Venezuela for many reasons: political unrest and safety; too much red tape; very difficult to communicate because of lack of infrastructure; poor and inaccurate medical information.” The accuracy of medical information is a bugbear that is common to many air ambulance operators, and that has been the discussion of many articles in ITIJ previously. Cuba – said Salinas – is a particular problem in this respect. To overcome this issue, the medical staff will always go to the bedside of the patient to ascertain their current medical status and ensure they are fit to fly. When the patient is found to be in a different condition to that which the team was expecting, communication becomes the number one priority. This involves the medical crew, the air ambulance company medical director, assistance company and insurer. Plans may have to change, with delays to departure and medical intervention performed if necessary. To facilitate this, all crews must have a satellite phone with them, as in many regions in the Americas, cell service will be poor to nonexistent.
For the assistance co-ordinators, there is perhaps a belief that there is simple process through which air medical providers go in order to send a plane to retrieve a patient – after all, these are companies that perform such missions on a daily basis. However, the process of dispatching an air ambulance on a mission is a decidedly complex one. One may wonder sometimes why the bills for air ambulance missions can amount to tens – or even hundreds – of thousands of dollars. The process involves mission control centre staff, pilots, mechanics, doctors, paramedics, administrative staff, ground ambulances, handlers and airport authorities. However, all these different cogs in the wheel have to co-ordinate perfectly in order for a smooth repatriation to take place, and this perhaps gives the first indication of where the value comes for insurers who need a comprehensive and quality service from their air ambulance partners.
Communication with the assistance team is essential, throughout the process – from the first call to get a quote for the flight, to ensuring everything is going to plan, and then ultimately to confirm safe delivery of the patient to their home country. The assistance company has to have a lot of faith in their air ambulance partner that they are going to deliver on their promise of safe, high-quality medical care, and while they can rely on word of mouth, accreditation and a shiny website, nothing beats seeing the operation in person. This, however, doesn’t happen as much as it should, according to Salinas. “We do not have too many visits from clients. I believe that by visiting us and knowing the aircraft and the process, we could have better outcomes for all involved.” He continued: “We need improved communication between the different teams.”
Part of the problem, said Salinas, is that there is a high staff turnover rate in the assistance industry. Perhaps this is why it is difficult for an assistance company to see the value in properly educating their teams about the inner workings of air ambulance operators. After all, where’s the return on investment in sending a team of co-ordinators to an air ambulance base so they are able to truly and deeply understand air ambulance operations if the employees aren’t it for the long haul (pun intended)?
Better communication has other benefits as well, as Salinas explained: “I don’t think people really understand how to save money when using an air ambulance. Better communication among assistance competitors would increase the utilisation of empty legs or shared flights (double stretchers).”
Come fly with me!
As a EURAMI-accredited provider, Jet Rescue has performed its own due diligence on its operations, but the team would like to extend an invitation to ITIJ’s readers to come and see for themselves the intricacies of an international fixed-wing air ambulance company. Indeed, there are few air ambulance operators to whom ITIJ has spoken that would not welcome visits from their assistance company colleagues. By improving communication and offering complete transparency in the travel and health insurance sector, all parties involved in the repatriation process will reap the benefits – including the patients. ■