In the fast-paced world of air medical services, staying ahead of the curve is crucial. One way to ensure that we meet and exceed industry standards as an organization is through simulation education, a method that mirrors real-life medical scenarios for training purposes. Recently, Air Methods achieved a significant milestone by earning Simulation Center Accreditation from the Society for Simulation in Healthcare (SSH). Air Methods was the world’s first air medical program to earn this prestigious accreditation. In this blog post, we’ll talk about what simulation education entails, how we use it, and the importance of this accreditation for Air Methods and within the industry.

What is Simulation Education?

Simulation education at Air Methods uses realistic scenarios to train clinicians. It involves various methods, such as virtual reality (VR), didactic learning, cadaver labs, and physical manikins of varying fidelity. These simulations offer a risk-free environment where professionals can practice and hone their skills, preparing them for real-world clinical situations.

“Healthcare simulation is a vital tool that allows air medical programs to prepare for the complexities and high-stakes scenarios our clinical teammates face every day.” said William Belk, Director of Medical Simulation and Innovative Education, “By replicating real-world situations in a controlled environment, we can practice, refine, and master the skills needed to deliver critical care in the HEMS environment. This level of preparation is essential for ensuring that our teams are ready to respond effectively to any patient encounter.”

Simulation training is invaluable in healthcare because it provides hands-on experience without patient risk. Practitioners can make and learn from mistakes in a controlled setting, ensuring they are better prepared for clinical situations. This form of education enhances critical thinking, clinical decision-making, and procedural skills through deliberate practice and guided self-reflection.

Understanding SSH Accreditation

The Society for Simulation in Healthcare (SSH) accredits programs that adhere to the highest standards in simulation education. Accreditation ensures that a program follows best practices and maintains a high level of standardization, which is crucial for learner safety and ensures the program is delivering high quality education.

The accreditation process under SSH is rigorous. In 2020, we began revamping our simulation education program, rewriting policies and procedures to align with the Healthcare Simulation Standards of Best Practices published by the International Nursing Association of Clinical Simulation and Learning, as well as other published standards and industry best practices.

Now that we are fully accredited, Air Methods is committed to maintaining these high standards. The accreditation is valid for five years, but we must submit annual reports to SSH to ensure continuous improvement and adherence to best practices.

Significance of Accreditation with SSH

Air Methods is the first air medical program to receive SSH accreditation, aligning itself with experts across the healthcare field, including hospitals, and major universities. This accreditation signifies quality assurance and credibility, validating that Air Methods’ practices are on par with those of industry leaders.

A critical aspect of SSH accreditation is creating a psychologically safe learning environment. Air Methods encourages open communication, where learners can ask questions and acknowledge what they don’t know without fear of failure. This approach contrasts with traditional clinical training methods, fostering a more supportive and practical educational experience.

Air Methods’ achievement sets a new benchmark for the industry, encouraging others to follow suit. By raising the bar, we aim to create the best possible learning experiences for our students, ultimately leading to better-prepared healthcare professionals who can save lives.

“Our recent SSH accreditation is a testament to the collective effort and dedication of the entire clinical education team at Air Methods. Over the past several years, we’ve worked tirelessly to elevate our simulation-based education, refining our practices and enhancing the learning experiences for our employees and customers,” said William Belk, Director of Simulation and Innovative Education at Air Methods. “This achievement is not just a milestone but a reflection of our commitment to excellence in critical care transport education.”

To be the first air medical program to achieve Simulation Center Accreditation is more than just a badge of honor; it’s a commitment to excellence in clinical education. Our simulation training programs are designed to provide clinicians with the skills and confidence they need to excel in their field. By setting a high standard, we are enhancing our training programs and inspiring the entire industry to strive for better practices.

Our Simulation Facilities & Training Methods

Air Methods has established four state-of-the-art simulation education facilities in Georgia, New York, Colorado, and Arizona. Each facility offers comprehensive training programs for clinicians that include multi-day sessions. These programs cover various aspects, such as trauma care, invasive procedures, and advanced medical topics in critical care transport.

Air Methods brings out its clinicians at least once a year for an extensive training session, where they run through educational simulations and receive updated training. An annual needs assessment is also conducted to evaluate our training requirements and the industry’s needs. The assessment ensures that the training provided is relevant and updated to align with needs of our providers and patient population.

The facilities offer a wide range of training methods, including:

• Virtual Reality (VR): Immersive experiences that replicate real-world scenarios.

• Didactic Learning: Traditional classroom-based education.

• Cadaver Labs: Hands-on anatomical training on human tissue.

• Manikin-Based Simulation: Realistic practice on task trainers and high-fidelity patient simulators.

Through the Air Methods Ascend program, we extend these training opportunities to not only our partners but also clinicians outside our network. This inclusivity allows a broader range of healthcare professionals to benefit from our advanced training methods.

“By setting a high standard of care and continuously striving for excellence, we not only benefit our organization but also set an example for the entire industry,” said Air Methods VP of Clinical Services, Stephanie Queen. “Through our dedication to innovation, collaboration, and patient-centered care, we push the boundaries and help drive the industry forward towards a brighter future.”

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In the aviation industry, safety is a priority. But it’s also a fundamental way of life, particularly in high-risk sectors like air medical services. Air Methods relies on its Safety Management System (SMS) program to establish a comprehensive systematic approach to safety, serving as the cornerstone of our company. It’s the backbone of our operations, ensuring that every flight is as safe as possible for patients and flight crew. With an unparalleled personal and financial commitment to our SMS, Air Methods has set the benchmark in air safety management.  

What is a Safety Management System Program?  
A Safety Management System program is precisely what it sounds like — a method for proactively mitigating risk to operations. It involves structures, procedures, practices, and policies to handle safety risks. The Federal Aviation Administration (FAA) describes it as a “formal, top-down, organization-wide approach,” and having one ensures “the effectiveness of safety risk controls.”  

Air Methods’ SMS program has several components, which include:  

• A Safety Management System Manual  

• Safety risk assessment and reporting tools 

• A Flight Operational Quality Assurance (FOQA) program 

• Safety promotion campaigns: “Safety Moment” of the Month 

Until recently, the FAA did not require Part 135 operators (providing on-demand services like air ambulances) to have a safety program. Air Methods voluntarily implemented a safety management system to promote proactive safety practices. Following a federal ruling, most Part 135 operations will now adhere to the Department of Transportation and the FAA’s safety management system requirements, though not all. Operators impacted by the new rule are expected to comply by around May 2026, pending a final decision. 

What the FAA’s New Requirement Means 
It is crucial that the FAA requires that most Part 135 operators follow safety procedures and have a formal Safety Management System program. 

“Under the current voluntary program, it means that Air Methods has put into practice all relevant procedures required under the federal mandate,” says Caleb Luck, Safety Department. “To maintain acceptance, along with the active maintenance of our program and as part of the new standard, we must maintain a state of continuous improvement to our program.”  

Part 135 operators rely on this program significantly. It allows us to maintain uniform standards while flexibly adapting to individual operational contexts. “This program also helps us navigate risks within our organization and foster collaboration using a shared approach,” explains Caleb.  

The Key Components of an Effective Safety Management System  
To ensure a safe and secure working environment, organizations today need to have a robust SMS in place. An effective SMS program encompasses several key components that promote safety and minimize workplace risk.  

These components include: 

Safety Policy: Establishes senior management’s commitment to safety and defines methods and processes that will meet safety goals. 

Safety Risk Management: Assessing acceptable risks helps determine the necessity and effectiveness of implementing new or updated risk management measures. 

Safety Assurance: Assesses the ongoing efficiency of applied risk control tactics and aids in pinpointing fresh hazards.  

Safety Promotion: Training, communication, and other efforts are essential for fostering a culture of safety across all levels of the workforce. 

Specific Benefits of SMS-Certified Operations for Partners and Patients 
Our ongoing efforts to enhance our SMS program ensure the highest level of safety for all. We routinely monitor the program’s effectiveness and make sure it retains high standards for our employees, partners, and patients. This commitment is evident in our evolving platform, where employees can easily report concerns with the assurance that they will receive prompt action. 

For Example, multiple reports were submitted by flight crews regarding the deficiency or absence of quality hazardous terrain and flight awareness systems across various aircraft within the fleet. These systems are essential for providing flight crews with information about nearby terrain and other aircraft. The safety management and aviation teams concluded that further discussion on this matter was necessary. As a result, immediate updates were implemented for aircraft with a critical need for these systems, accompanied by a phased-out plan to ensure the installation of new systems in other specified aircraft over time. 

The Role of the SMS Program Within Air Methods 
The SMS program at Air Methods sets the stage for fostering a strong safety culture within the organization by setting clear expectations for all employees and outlining the two fundamental principles. 

These are:  

1. Accountable Executive (AE) Involvement — The CEO is the AE for Air Methods, ensuring adherence and continuous improvement of the Safety Management System. 

2. Just Culture — The principle establishes a shared accountability system that encourages employees to report hazards and self-deficiencies without fear of retribution or undue discipline. This enables the organization to proactively identify and address potential safety issues. By prioritizing safety and emphasizing accountability at every level of the organization, Air Methods’ SMS program sets the tone for a robust safety culture that keeps employees, customers, and communities safe. 

Upcoming Enhancements 
As we continue to evolve our safety culture, we are implementing new updates to our SMS program. In early June, we will see the release of a new tool for safety reporting that includes a Corrective/Preventative Action Plan (CAPA) tool. These tools will enable us to proactively identify hazards and unmanaged risk, respond more effectively, and ultimately decrease the risk of incidents and accidents from occurring.  

We are confident that our SMS program will continue to evolve and adapt to meet the industry’s changing requirements. We will continue to work closely with the FAA to ensure we stay ahead of the curve and remain at the forefront of safety in the aviation industry. With the recent mandate for Part 135 operators, we have been working diligently to stay ahead of the changes that will impact the SMS landscape. 

Learn more about safety practices at Air Methods.  

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On Armed Forces Day (third Saturday of May), we honor all the members of our Army, Navy, Air Force, Marine Corps, Space Force, Coast Guard, National Guard, and Reserve forces. United by a common call to serve, these brave men and women represent the very best of our nation. Like the members of our armed forces, all of us at Air Methods are committed to our mission to serve others. One teammate’s journey highlights the grit and determination required to serve in both the military and the emergency air medical industry.

For more than 25 years, Area Manager Chuong Nguyen served in the United States Marine Corps. The courageous and resolute spirit Nguyen displayed in the military was born in the challenges of his childhood.

Nguyen is a refugee from Vietnam, and his journey to America began at just 10 years old. He tried to escape Vietnam three times before he was successful. It was through the help and encouragement of family members and over the years that kept his perseverance alive. In his attempts to escape, he was held captive, experienced brutal conditions while stowed in malfunctioning fishing boats, and was on the brink of starvation several times. However, the taste of freedom far outweighed the dangers of fleeing. Nguyen’s commitment to a better life was realized when a U.S. Navy ship rescued the fishing vessel he was on, where his third and final attempt to escape was successful.

“For me to be able to see Old Glory (U.S. flag) flying on the ship that day, left me without words,” said Nguyen, recounting the day his life changed forever. “Sharing this part of my story now, having served in the Marines and serving our country, is even more meaningful to me.”

Finally arriving in America with his aunt and uncle, after seeking asylum in the Philippines for more than a year, he entered 7th grade and over time, Nguyen and his family worked to establish themselves. In his senior year, Nguyen had no plans after graduation. It wasn’t until he saw a postcard that read, “The Few. The Proud. The Marines,” that caught his attention.

“The postcard had a Marine that looked real tough,” said Nguyen. “I looked up the word ‘infantry,’ as it was a job opening listed on the card, and thought, ‘That’s something I want to do.’”

Still a minor, Nguyen’s uncle signed the paperwork for him to enlist in the Marine Corps. Throughout his years of dedicated service, Nguyen earned his way to the highest enlisted rank as a Sergeant Major.

“I grew up in the infantry. I’ve always known honor before self, and I knew in life after the Marine Corps I wanted to continue serving others,” said Nguyen.

After transitioning from the military five years ago, Nguyen polished his LinkedIn profile, and it was there that a representative from a recruiting firm connected with him to explain he would be a good fit for a role with Air Methods. While having no clinical or aviation experience, Nguyen recognized Air Methods offered the opportunity to be part of a higher purpose. After several interviews, he was offered the opportunity to become an area manager in California.

“At Air Methods, I’m part of a team, a team that counts on everyone to fulfill the mission, and I am honored to be a part of it,” said Nguyen. “I tell my teammates often, ‘What you do matters. What we do matters.’ I want to instill in them the confidence they are the best at what they do and who they do it for. To be part of a team like that is truly an honor.”

The courage and commitment Nguyen demonstrated as both a refugee and a member of the United States Marines are found in many of our teammates. The ongoing training, standing ready to serve whenever called upon, and upholding our mission to save lives reflect these values.

More than one-third of our teammates have military backgrounds. As we look to celebrate Armed Forces Day on Saturday, May 18, we salute those who selflessly and bravely served and continue to serve our country.

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In the demanding and fast-paced world of healthcare, burnout has emerged as an all-too-common condition that affects medical professionals tasked with delivering high-quality care around the clock. Combatting healthcare worker burnout is crucial for the well-being of providers, patients, and the overall quality of care. Addressing this problem extends beyond staff welfare and turnover; it’s crucial to maintaining a high standard of healthcare delivery. We will explore the extent of healthcare worker burnout and have compiled five actionable strategies to avoid burnout, ensuring our healthcare providers are supported, healthy, and equipped to deliver the best possible care. We’ll also discuss ways Air Methods is tackling burnout.  

Understanding Burnout Among Healthcare Professionals 

Burnout in the healthcare sector is not a new occurrence, but its impacts on physicians, nurses, and staff have become more profound than ever before. Frontline healthcare workers have reported experiencing burnout at astonishing rates — in 2022, 46% of health workers reported feeling burned out often compared to 32% in 2018, according to the Centers for Disease Control and Prevention. This increase underscores a crisis that not only affects individual practitioners but also the quality of patient care within our healthcare system. 

Burnout arises from prolonged or repeated stress, leading to emotional, physical, and mental exhaustion. In the context of healthcare, this condition often emerges from the high-pressure environment in which workers must maintain a continuous state of alertness and moral and professional responsibility. Burnout manifests through three primary dimensions: 

1. Emotional exhaustion: Caregivers feel drained and unable to muster the energy for continued emotional involvement with their patients. 
2. Depersonalization: A defensive response to overwhelming demands, leading to a cynical attitude and emotional detachment from the job and patients.
3. Reduced personal accomplishment: Professionals feel a decline in their sense of achievement in their work.

Causes of Burnout in Healthcare 

Several factors contribute to the rise of burnout among healthcare professionals, but a few stand out: 

• Excessive workloads: Insufficient staffing levels lead to longer shifts and more patients per caregiver, leaving less time for rest and recovery. 
• Intense emotional involvement: Dealing with patients’ suffering, critical decisions, and sometimes the death of a patient can take a significant toll. 
• Lack of control: A feeling of helplessness when faced with an overload of bureaucratic tasks and limited resources or autonomy. 
• Work-life imbalance: Difficulty in separating personal life from professional life, often due to extended hours and on-call demands. 

The dedication of frontline healthcare professionals is often at odds with the demands placed upon them by an overburdened healthcare system. It is important to recognize that the exhaustion, stress, and emotional strain workers experience is not a reflection of their capability, but rather indicative of shortcomings in our healthcare system.  

“The U.S. healthcare system is difficult to navigate,” said Emily Colyer, Director of Patient Safety at Air Methods. “We’re working in a fragmented and inefficient system where there are constraints on simply doing the right thing for the patient. When these barriers make employees feel their work is not making a difference, they feel burned out.” 

These constraints in our healthcare system are pushing healthcare workers over the edge. According to the U.S. Surgeon General, workers “are at an increased risk for mental health challenges and choosing to leave the health workforce early. They work in distressing environments that strain their physical, emotional, and psychological well-being.” 

Burnout can often creep up silently on healthcare professionals. According to experts from UNC Health, key signs of burnout in workers and providers include “emotional exhaustion, depersonalization, and a reduced sense of accomplishment or loss of meaning in their work.” Behavioral changes like heightened irritability or frustration often accompany sleep disturbances like oversleeping or insomnia, which should not be overlooked. Physical manifestations may present as jaw clenching or teeth grinding. The ramifications of burnout extend beyond mental well-being to potentially severe consequences like hypertension, depression, substance misuse, strained personal relationships, and an upsurge in professional errors. It’s important to acknowledge these warning signs and seek professional intervention promptly to mitigate the adverse effects associated with burnout. 

5 Tips to Avoid Burnout at the Workplace 

Preventing burnout and related mental health challenges requires a joint effort between employers and our healthcare system. Health workers can also implement strategies to avoid burnout and enhance their well-being.  

Air Methods offers these five tips that may help healthcare workers who are feeling burned out on the job.  

1. Establish Boundaries to Separate Work from Personal Life 

Setting clear boundaries is essential for work-life balance. It’s critical to have time when you are not “on call” for work-related concerns. This means turning off work phones or emails during personal time and communicating your availability to colleagues and supervisors. Even small changes, like refraining from discussing work topics during meals, can go a long way. 

Tip: Utilize email autoresponders and voicemail messages to inform others when you are unavailable, and they can expect a response. 

2. Engage in Regular Physical Activity 

Exercise is widely recognized for its ability to relieve stress and improve mood by triggering the release of endorphins. Even short, consistent bouts of physical activity can make a dramatic difference in managing stress levels and improving overall well-being. 

Tip: If time is scarce, consider short 10 to 15-minute brisk walks during breaks, or try a quick high-intensity interval training (HIIT) workout in the morning to jumpstart your day. 

3. Build a Support Network 

A robust support network can provide an outlet for discussing and managing the emotional demands of healthcare work. This network might include co-workers who understand the unique pressures of the job, as well as friends and family members. Air Methods has established a peer well-being program called SIREN that can help.  

Tip: Organize regular meetups or check-ins with your support system to decompress and share experiences. 

4. Prioritize Sleep and Nutrition 

Adequate sleep and proper nutrition are the building blocks of mental resilience. They help maintain focus, energy levels, and emotional stability, all key for preventing burnout. 

Tip: Create a sleep-conducive environment by minimizing electronic device usage before bed, establishing a relaxing pre-sleep routine, and having a consistent sleep schedule. Plan meals to ensure you have access to nutritious food during busy workdays. 

5. Practice Mindfulness and Relaxation Techniques 

Mindfulness practices such as meditation, yoga, or deep-breathing exercises can mitigate stress and enhance feelings of calm and presence. Even a few minutes a day can make a significant difference. 
 
Tip: Use mobile apps designed to guide mindfulness exercises, and allocate a fixed, short period each day to practice these techniques. 

These tips can help healthcare workers when feeling overwhelmed on the job, but workplace support is just as important. Colyer emphasizes that leadership support is crucial to attracting, recruiting, and retaining teammates. “Leaders work hard to keep their teams engaged while trying to remove barriers that promote workplace burnout. When leaders support frontline teams, employees’ work remains consistent with a company’s mission and promotes retention.” 

How Air Methods is Taking Action 

As a company deeply committed to the well-being of its employees, Air Methods understands the serious impact of burnout and high stress. We have established a peer well-being program called SIREN (Stress Intervention & Recovery Employee Network) aimed at providing professional, empathetic support to combat the stress and burnout so common in healthcare environments. 

“In the short time SIREN has been in action we have seen many of our teammates greatly benefit from the support this team provides We are excited to see what the future holds for this team and the many people we can help.” -Sheryl Williams, Health & Wellness Manager at Air Methods 

Here’s what employees can expect with SIREN: 

• Access to Peer Support Specialists (PSS). Air Methods has trained a team of PSS personnel who are ready to lend an empathetic ear and support their colleagues. These specialists are equipped to help with the unique pressures that come with life in the air medical industry. 
• Training and expertise. Each of our Peer Support Specialists is a current Air Methods teammate and has completed extensive training in active listening and support for work-related stress. They can identify when professional resources may be necessary and can provide appropriate referrals. 
• 24/7 availability. The SIREN Hotline offers around-the-clock support through both calls and texts, ensuring that employees have access to assistance whenever it might be needed. 

• Proactive assistance for clinicians. During the Protean Peer Review process, clinicians have the option to notify the SIREN team about particularly challenging flights. This system allows the Peer Support Team to proactively reach out and offer support. 
• Customizable support. Recognizing the diversity of its team, Air Methods allows employees to request a Peer Support Specialist who shares a similar background or set of experiences, tailoring the support to the individual’s specific needs. 
   

It is essential to understand that burnout is not merely a personal issue — it’s a complex phenomenon that reflects systemic problems in healthcare environments. Addressing burnout requires a concerted effort from all levels of the healthcare structure, with the understanding that taking care of caregivers is just as critical as caring for patients. Air Methods supports our healthcare workers with a specialized program to help meet the needs of our staff. Healthy, engaged professionals form the backbone of a thriving healthcare system at Air Methods, supporting our mission to provide exceptional air medical care. 

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February is American Heart Month, a month dedicated to promoting heart health and recommitting to our cardiovascular wellbeing. We also acknowledge pivotal programs like Mission: Lifeline^®, a national American Heart Association initiative. Their goal is to revolutionize the system of care for patients facing critical heart-related emergencies. Mission: Lifeline® unites healthcare professionals and stakeholders to significantly raise survival rates and improve the quality of care for patients being treated for cardiac events. Their recognition system is well known throughout the country and celebrates hospitals and EMS agencies that consistently excel in timely, evidence-based care for acute heart conditions.

“Mission: Lifeline® gives us a roadmap best practices to deliver the best possible patient outcomes of STEMI and Stroke care.  Air Methods provides our hospital and EMS partners a means to provide rapid and highly acute patient transport in order for them to obtain Bronze, Silver and even Gold recognition.” said Air Methods VP of Clinical Services, Kelly Miller.

At Air Methods, we are proud to play a key role in this life-saving initiative by providing indispensable support through:

• Early Activation Policy: Our collaboration with 911 centers allows for helicopters to be placed on standby during initial emergency calls, ensuring rapid deployment when first responders request our launch to the scene.

• Interfacility Early Activation Policy: Hospitals can contact their local air medical service on-demand and have a helicopter arrive at the hospital while essential tests and acceptance at the receiving facility are being arranged.

• Consultation Services: Our account executives are on hand to aid in the critical decision-making process, evaluating the most efficient transfer method, whether by ground or air, to ensure STEMI patients receive care within the golden hour.

• Fast Request Methods: Through tools like the Early Activation Button, Direct Dial Phone, and the Air Com App, we’ve streamlined the process of summoning air medical assistance, making it a swift and seamless action.

• Clinical Coordination: Our on-board flight nurses and paramedics are equipped to transport patients requiring post-fibrinolytic care, ensuring continuous treatment during transfers.

“Time equals muscle for our STEMI patients and brain for our Stroke patients,” Kelly explains. “Air medical transport, when activated early, will improve patient outcomes and save lives.”

Air Methods is dedicated to assisting EMS and hospital personnel in delivering the highest standard of patient care possible. Our air medical services directly impact the AHAEMS8, AHACAD9, and AHACAD23 recognition criteria across EMS, Receiving Center, and Referring Hospital programs. View the criteria here. If you are interested in partnering with Air Methods to increase quality of care and potentially receive Mission: Lifeline® recognition, click here and your local Air Methods representative will get in touch.

Concepts, research, and solutions pertaining to this article were contributed to by Aidan O’Connor, NR-P, FP-C, Regional Sales Director at Air Methods, and William Kelly Miller, Vice President of Clinical Services at Air Methods.

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Air medical transport has been facing challenges in recent years, with a few emerging trends currently at the forefront. We are seeing changes in the industry emerge, from staffing shortages and increased specialty transports, to feeling the effects of the No Surprises Act. As we approach the end of 2023, we want to share the top three trends that we have observed here at Air Methods. 

1. Staffing Shortages

The industry, including medical transportation and healthcare facilities, is being heavily impacted by staff shortages affecting roles such as pilots, healthcare workers, and maintenance technicians. The presence of skilled personnel is crucial for providing high-quality care. However, it’s not just the medical transportation industry that’s grappling with these challenges. Hospitals and health centers are also struggling to maintain adequate staffing levels. Many rural communities are facing the decision of closing beds or units due to insufficient staffing. In some cases, specialty services like Labor and Delivery are being cut back. These shortages are placing enormous pressure on local ground transport and air services to ensure patients receive the necessary level of care. 

Key insights into the reasons behind staff shortages: 

A critical factor behind the shortage of medical professionals in the air medical industry is the high demand for their services. As the population grows older and medical emergencies become more frequent, the need for skilled practitioners and pilots in air transportation is rising. Becoming a qualified medical professional in this field requires rigorous training and extensive financial investment, which can put off some individuals from pursuing careers in healthcare. Furthermore, the competitive job market for healthcare and aviation sectors makes it challenging for the air medical industry to attract and retain top talent. 
 
Meeting strict safety and regulatory requirements also presents challenges for professionals working in air medical transport. The aviation and healthcare industries are both highly regulated to ensure the safety of patients and crew. This demonstrates the need for constant training and certification in addition to experience, which adds even more pressure to an already high-stress environment. Workload and stress are other significant factors associated with the air medical shortage crisis. Air medical professionals frequently face demanding work schedules and high-stress situations, which can lead to burnout and affect employee retention rates. 
 
Overall, these challenges contribute to a shortage of medical professionals in the air medical industry, a crucial component in transporting critically ill or injured patients quickly and efficiently. 
 
Read more about pilot staffing shortages here. Read more about clinical staff shortages here. Read more about AMT staff shortages here. 

2. Increasing Demand for Specialty Transport

Specialized transport is on the rise, particularly in the fields of pediatrics and cardiovascular care. This includes transporting pediatric patients and newborns in the neonatal intensive care unit (NICU). We have also seen an increase in cardiovascular assist device transports for patients that require specialized interventions like IABP (intra-aortic balloon pump), Impella and ECMO (extracorporeal membrane oxygenation).  

Key insights into reasons for increase in specialty transport: 

The number of patients being transported by air has grown in recent years due to several factors. One of them is the regionalization of care as healthcare systems concentrate specialized services in specific hospitals. This often means that patients need to be transported from one facility to another, and air transport is crucial for ensuring they have access to these specialized centers. In addition, advances in neonatal and pediatric care have expanded the range of conditions that can be successfully treated in pediatric patients, making air transport an even more viable option for critically ill children. 

Another factor driving the increase in air medical transport for patients is the growing awareness and utilization of this service. Healthcare providers, emergency medical services, and the public are becoming more aware of the benefits of air medical transport. Increased awareness and utilization of air transport services can provide a critical link in the chain of care, helping ensure that patients receive the specialized care they need in a timely manner. 

Population growth is also contributing to the rise in air transport. With more and more people living in urban areas, traffic congestion on the ground is often a factor that can hinder the safe transport of critically ill patients. This increases the need for air transport, which can bypass ground traffic and quickly bring patients to the medical facility they need. 

Read more about the increase in pediatric specialty transport here. Read more about the increase in cardiovascular specialty transports here.  

3. The No Surprises Act’s Impact on Medical Transport  

The No Surprises Act went into effect in 2022 for the air medical industry. This is a law that Air Methods strongly supports as it removes patients from the middle of any billing dispute between medical providers and insurers, thereby protecting patients from “balance bills.” Now, when an out-of-network insurance company refuses to cover or under-reimburses for an emergency air transport of one of its customers, the air medical provider and insurer can enter an independent dispute resolution (IDR) process to resolve the billing dispute. This new system eliminates the possibility that a patient could receive a bill for unpaid transport. Unfortunately, the IDR process has been structured to favor insurance companies rather than air providers, particularly those in rural areas, and these remaining out of network health plans have pursued tactics of delaying payment or underpaying for critical services. While Air Methods has been a leader in the industry going in network and today is 76% percent in network with health plans, we have had to pursue the IDR process for the remaining out-of-network transports. We win these cases 87% of the time but it has delayed payments by months. States are looking at similar NSA-style initiatives for ground transportation, which may result in similar cost pressures for ground transport. We will have to wait and see if these changes result in loss of access to ground transport for patients leading to further demand on the air transport industry to fill the gap left by ground transportation, especially in rural America. 

Read more about the No Surprises Act and its impacts here.  

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Our goal at Air Methods is to provide the highest level of emergency medical services to our patients, and the cornerstone of achieving this goal is a highly trained pilot. The need for continual pilot training and simulation is essential in the aviation industry for safety, accuracy, and compliance. While training on an aircraft is necessary, practicing in a level D simulator is advantageous for our pilots. We’ll explore the advantages of training in simulators and why it’s so critical. 

About Level D Simulators  

In 2015, we began leasing level D simulators from FlightSafety International, a company that offers extensive, full-flight simulators used for training commercial, government, and military organizations. Air Methods employs in-house instructors to conduct pilot training on these 15-million-dollar simulators. Air Methods pilots currently train in them across nearly all major airframes in the fleet. 

Level D simulators are the gold standard of flight training because they provide a realistic training environment. Our pilots get the closest experience to actual flying in the simulator and it’s the only non-aircraft training method accepted by the FAA.  

Advantages of Simulator Training  

There are several advantages for pilots when training in a level D simulator. For starters, pilots can train dangerous scenarios like engine failures and loss of tail rotor thrust without risking lives. They can also train better for emergencies and incidents by repeating certain scenarios and stopping to talk, evaluate, and retrain until they can accomplish them correctly. Using a simulator allows pilots to reset scenarios quickly, providing effective training in less time. An added benefit of utilizing a simulator also means that no air base is taken out of service for training exercises. For Air Methods pilots, most training is now done in a simulator which is also the same standard for commercial airlines.  

“Level D simulators are an especially great training tool to get comfortable with the aircraft instruments for pilots transitioning from fixed wing aircraft to rotor wing and for pilots transitioning to a new aircraft model.”  -LifeNet Pilot Shawn Miller 

What Is Involved in Simulator Training 

Employee simulator training is a significant part of Air Methods’ training requirements. Before pilots can be hired as a HEMS (Helicopter EMS) pilot, they must have logged at least 2000 hours of flight time. This standard is set high to ensure that each Air Methods pilot is not only capable of doing their job, but capable of going above and beyond to provide the highest level of care. In fact, our requirement exceeds the FAA standard by eight hours in the simulator.  

Simulator training involves one to two recurring training events per year for current Air Methods pilots, each lasting three to five hours. Additionally, simulators are used to train maintenance personnel. 

Applying Specific Scenarios During Drills  

In single-engine, VFR helicopters, simulators are crucial for effectively practicing flights where cloud cover is present. Typically, when training without a simulator, pilots will use eye covers for this specific drill which isn’t as effective. But in a simulator, pilots repeatedly practice these challenging scenarios. Since incorporating simulators for practicing a drill in a single-engine, VFR scenarios, no crashes have occurred in this scenario at an Air Methods base. 

During reoccurring annual training, an experienced pilot in Arizona requested additional practice with engine failure and emergency landing scenarios. Less than a month later, the pilot encountered an engine failure incident in the field and successfully performed an emergency landing without any additional damage to the helicopter or its crew. 

What’s Coming Next  

In 2024, a new initiative called “Mission Training” will be implemented for each new hire. Previously, pilots were trained individually on specific aircraft and scenarios. However, with scenario-based immersion training, trainees will go through the entire process of an actual flight, including working with the team and conducting safety risk assessments. This comprehensive training aims to provide a clearer understanding of the day-to-day responsibilities of an EMS pilot, resulting in better preparedness for new pilots. 

Air Methods strives to achieve the highest level of safety, professionalism, and care for each of its patients. Training our pilots using Level D simulators from FlightSafety International is efficient and provides a realistic training environment. It allows us to train and equip the best pilots the industry has to offer. Moving forward, we’ll continue to focus on employee simulator training, and driving the industry forward with the best EMS experience to patients.  

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What is GAMUT?

Air medical transportation plays a critical role in the healthcare industry, providing critical patient care while ensuring timely and safe transportation of patients to medical facilities. As the leading provider of medical transport services across the U.S., Air Methods has been leveraging the power of data to enhance its services and improve patient outcomes. One of the key tools in our arsenal is the Ground & Air Medical Quality Transport (GAMUT) quality improvement collaborative.

GAMUT is a data analytics tool that enables our company to monitor, analyze, and assess performance using quality metrics specific to medical transportation. It is a unique initiative that brings together over 350 critical care transport programs of all sizes, providing a collaborative platform for sharing data and best practices. Air Methods submits data to GAMUT every six months. After submitting, the program sets parameters and monitors the data to guarantee accuracy and integrity. This helps to prevent data manipulation and ensures that the metrics are reliable and standardized across the air medical industry.

Why Do Critical Care Programs Use It?

The key benefits of GAMUT are in its ability to create an industry benchmark, allowing critical care transport providers to assess their performance in comparison to other programs and pinpoint areas for improvement. In the past, providers have been hesitant to share their quality data in fear of losing their competitive edge. GAMUT has changed this dynamic and brought about a culture of collaboration and data-sharing, leading to continuous improvement of patient care and safety.

Providing medical care to patients is complex, especially for the critically ill or injured patients that Air Methods treats and transports. “In order to judge the quality of care, we need to measure our clinical performance,” said David FE Stuhlmiller, MD, FACEP, FAEMS, CMTE, an Air Methods Physician Advisor. “While every critical care transport service strives to continually improve their own performance, and should continue to do so, before GAMUT, critical care transport services had no idea if their clinical performance was better or worse than that of other services.”

GAMUT is championed by the Air Medical Physician Association (AMPA) as the first community-wide attempt to benchmark specific clinical performance measures in the critical care transport setting. A benchmark is the standard against which a measurement can be compared. In healthcare, ideally the benchmark represents an evidence-based best practice.

In 2013, AMPA requested transport medicine programs to submit their quality metrics and then vote on their importance. Representatives from the medical transport community gathered in Denver to finalize the first 22 GAMUT metrics for benchmarking. Air Methods, with five clinical leaders involved actively participated in this effort.

Air Methods immediately contributed data to 14 of the original 22 metrics and continues to support GAMUT by submitting data and participating in metric revision discussions.

Air Methods has witnessed the tangible benefits firsthand. The metrics and trends identified through GAMUT are used to make annual changes to clinical education and training programs. This enables Air Methods to stay ahead of the curve and deliver best-in-class patient care.

The metrics may seem like mere numbers on paper, but they have a real impact on people’s lives. Kelly Miller, VP Clinical Services, highlights that “these metrics are best practices that lead to safer patient care and more positive outcomes for our patients.” By keeping a sharp eye on the data, we can remain committed to delivering exceptional critical care services that improve patient outcomes and ultimately save lives.

There is value in assessing and comparing flight programs from around the world, not just at Air Methods, in order to enhance overall quality. “The averages across the board have been moving up because programs have been able to benchmark themselves against other similar operating bases,” said Miller.

GAMUT is an invaluable program that is driving significant improvements in the medical transportation industry. By sharing data, collaborating, and benchmarking against industry standards, providers can deliver safer, more efficient, and more effective life-saving services. Air Methods’ partnership with GAMUT is a testament to its commitment to delivering quality care and staying ahead of the curve. Learn more about GAMUT or learn more about Air Methods commitment to clinical excellence.

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Selecting a Landing Zone

Our helicopter pilots face the challenge of finding a suitable landing zone for their aircraft, and quickly when transporting emergent patients. Several factors come into play as pilots try to locate the best possible spot to land safely — location, accessibility, and safety are all critical. 

Safety is the top priority for a pilot who needs to assess the terrain and surrounding obstacles to ensure the landing zone can accommodate the aircraft and allow for a safe landing and takeoff.  Wires, cranes, and antennas are a hazard and difficult for pilots to see when landing. Additional hazards can include unsecured items within the landing zone area, or even obstacles not visible to the pilot such as natural or manmade items hidden in tall grass. This includes small items such as plastic bags.

Tip: Coordinate with ground and air by using radio frequencies and key phrases with critical information to enable a safe landing and takeoff. 

Another important priority to consider is accessibility. The landing zone needs to be easily accessible for medical personnel or other emergency responders who attend to patients or unload equipment. Terrain can play a significant role in this, as pilots may need to navigate steep or uneven slopes to reach the landing site. 

Factors to consider when selecting a landing zone: 

• Ground must be firm and flat with no more than a 5-degree slope. 
• Area must be clear of boulders, logs, livestock, and other obstacles. 
• Tall grass needs to be pressed for a flat and clear landing. 
• If landing on a highway, the helicopter should be a safe distance from the accident with minimum 100 foot surrounding clearance for daytime and 150 foot surrounding clearance for nighttime. 
• Headlights and emergency vehicle flashing/rotating lights should be minimized at nighttime to minimize impact on night vision devices worn by the pilot.
• Vehicle traffic must not be able to pass until the area is clear.  

Setting up a Landing Zone 

Preparing a landing zone requires effective communication with other emergency personnel and thorough coordination of resources. You should have a cleared, visible, and well-lit landing zone. 

The first step is to clearly mark the landing zone on the perimeters with visible or  illuminated cones, which is either amber or red, at each corner. The pilot surveys the area upon arrival and will make the final decision on landing and how to maneuver and land the helicopter within the zone. 

While some pilots prefer not to have a ground guide, if one is utilized, they should stand at least 25-50 feet outside the landing zone and wear protective gear, including ear and eye protection and properly secured helmets, if available. The presence and location of a ground guide must be communicated to the pilot during initial radio communications.

Factors for ground guides to consider on final approach: 

• Be aware of approaching vehicles or pedestrians, particularly to the rear.
• Communicate to the pilot on landing zone readiness, obstacles, wind direction, and surface type. 
• Hazardous obstacles include wires, poles, and towers.
• When the helicopter is on final approach maintain radio and eye contact. 

Alternate Landing Zone Set Ups

When a routine landing zone preparation is not feasible, you can create an alternate method to maintain safety. If cones or perimeter illumination devices are not available at night, an “X” pattern made by shining headlights or floodlights from outside the downwind side of the landing zone can provide an effective way to guide the aircraft in. However, it’s crucial to never shine direct light into the face of the pilot which can be dangerous.

Additional Safeguards for Safe Emergency Medical Landings

To ensure a safe landing, there are additional measures pilots and ground crew can put into place, allowing medical teams to attend to patients without added danger. 

When approved first responder personnel are present, the pilot can request guards at the tail rotor but at a safe distance to keep people away from the dangerous tail rotor section. Before the aircraft departs, it’s necessary for all personnel to stand outside the landing zone to allow the helicopter to maneuver.

Tip: For safety, keep crowds, news media, and nonessential personnel at minimum 150 feet from the helicopter at all times. 

Personnel allowed in the landing zone perimeter, should not wear loose clothing including hats which could fly away. If carrying equipment or a patient, all blankets and straps must be secure, and stretchers must be carefully controlled around the helicopter.

Communications

When every second counts, clear communication is crucial for ground crew to guide emergency helicopter pilots. Communication should be established prior to arrival and through to departure. Any hazard warnings should be pointed out during the operation.

Designate one person to communicate to the pilot by two-way radio who will relay potential obstructions, hazards, and wind info to the pilot. This person will also describe positions using compass directions: “Fire truck is west of the landing zone,” or the clock method: “Fire truck is at your 11 o’clock position” with the 12 o’clock position reference using the nose of the aircraft.

Directive phrases:

“Go around” — A standard aviation phrase, “go around” is used when a hazard is identified during approach; the pilot will add power, pull up and go around.

“Stop, Stop, Stop” — When a pilot hears these words he is being warned of immediate danger and should hold position.

If able, provide descriptive information in the context of a directive phrase: “Go around, object in the landing zone.”

Hand signals:

The ground guide is responsible for providing hand signals to the pilot, using either their arms and hands during the day, and flashlights at night. These signals are used both upon arrival and departure, ensuring that every flight is communicated successfully. The pilot has the final say on whether to continue, regardless of ground guidance. This system ensures that emergency medical helicopters arrive and depart without confusion.

Approaching an Emergency Medical Helicopter

Safety is always top of mind when entering the landing space after an emergency medical helicopter has landed. Here are the most important tips to keep in mind to follow safety guidelines. 

• Only approach the helicopter after the pilot or crew member gives the signal. 
• Stay in the pilot’s view at all times. 
• Do not walk behind the helicopter at any time due to the tail rotor hazard.
• Only necessary personnel should approach the helicopter.
• Do not raise anything above shoulder level around the helicopter and carry all equipment at waist level such as IV poles.
• Do not open or close the aircraft doors.
• Crew members will direct the loading/unloading of the patient. Crew members will ask for assistance if required.
• No vehicles (including emergency vehicles) should be closer than 50 feet from the aircraft, and may be marshalled in by crew members.
• No smoking or running within 50 feet of aircraft at any time.
• Always exit the designated landing zone in the same direction that you approached the helicopter.

Securing an emergency medical helicopter landing zone is a critical aspect of transporting patients quickly and safely. The Air Methods team has compiled tips for creating a secure landing zone that will guide ground staff and helicopter pilots. With these points in mind, emergency medical helicopter landing zones can be secured with optimal safety and efficiency — saving precious time in transporting critically ill or injured patients. More information on air medical safety.

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“Anyone can cook, but only the fearless can be great,” said Auguste Gusteau in the movie, “Ratatouille.” Many say that about teaching. It may be possible for anyone to teach, but not everyone is a teacher. It takes passion to understand how adults learn and how to adapt educational content to different learning styles. My 15 years as a flight paramedic sparked my desire to share my experience with other professionals in emergency medical service (EMS). These dedicated clinicians must be ready to provide emergency interventions and stabilizing care under the most stressful and chaotic circumstances, including during transport by ambulance, fixed-wing aircraft, or helicopter. High-quality education programs, such as Air Methods Ascend, that use data to integrate safety and clinical excellence help ensure these clinicians have the skills and confidence they need to serve their patients.  

WHY DATA MATTERS IN CLINICAL EDUCATION   

EMS education programs have a high bar to meet in preparing clinicians for service. Therefore, these programs must continuously monitor performance and apply data-driven improvements.  

A program like Air Methods Ascend gathers a wide range of data both in the classroom and in the field. This allows for meticulous analysis of results to establish and monitor quality metrics, understand trends, and identify root causes when issues arise. In turn, these findings can be applied to continuously enhance both in-person and online programs.  

CASE IN POINT: EMERGENCY INTUBATION   

Airway management is crucial to emergency medicine. When a patient is in crisis, emergency clinicians must quickly and adeptly assess the patient’s condition and take action to clear the airway, up to and including intubation.  

The Air Methods clinical team has achieved a first-attempt intubation success rate of 99%, which dramatically reduces the risk of further complications to patients. This high success rate is the result of thorough, ongoing program assessment.  

To achieve this, we identified a change in success rates with airway management. We proceeded to complete a deep analysis to identify potential causes: Was the change related to clinician experience or time since their last training or something else? After identifying variations in technique as the cause, we reviewed our care protocols and our training curriculum for intubation to implement improvements. With data-driven analysis at the helm of the Air Methods clinical team, we continually provide high-quality clinical education through the Ascend program.  

EEFFECTIVE TRAINING PRIORITIZES HANDS-ON PRACTICE WITH DIDACTIC EDUCATION 

The review of education specific to intubation reinforced the importance of providing learners with engaging didactic training – not just boring, linear slide presentations – coupled with realistic hands-on practice. Hands-on experience using manikins and donor specimens, applied within a learning environment that embraces mistakes, helps clinicians improve skills, build muscle memory and gain confidence—a key element of the Ascend program. 

Ascend’s high-fidelity manikins, which are extremely realistic, are designed to interact and react as a real person experiencing a medical crisis. Manikins simulate clinical interactions with different types of patients, such as adult and pediatric patients, allowing clinicians to practice an entire care episode from meeting the patient, assessing their condition and symptoms, and proceeding with care, including performing procedures such as intubation.  

Proctored donor specimen labs provide the opportunity to perform a wide range of life-saving procedures, such as intubation or surgical airways, needle and tube thoracostomy, intraosseous needle placement, or emergent escharotomy. While many programs offer some access to donor specimens, the learner-to-specimen ratio is often as high as 40-to-1, giving people the opportunity only to observe. The better approach is to strictly limit ratios to 6-to-1, so that all learners have an opportunity to practice their skills. Ascend makes this possible.   

DATA DRIVES SAFETY AND QUALITY

By meticulously monitoring quality, safety, and performance in the classroom and in the field, Ascend’s clinician education programs are at the forefront of employing evidence-based care protocols. With Ascend’s high-quality education programs that are engaging and cognizant of different learning styles, clinicians will gain the skills and confidence they need to provide life-saving care to their patients. In addition, offering high-quality, interactive training helps overcome today’s staffing challenges to attract and retain clinicians in EMS careers.  

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Darrin Buchta is the Clinical Education Manager for Air Methods. He holds a Master’s in Adult Education and a Bachelor’s in Homeland Security and Public Safety. He is currently working towards earning a Bachelor’s in Nursing. 

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