BBC world service program about USA HEMS

[cats_five]

BBC World Service - The Truth About ..., Success and Failure in Medicine, The Business of Failure (http://www.bbc.co.uk/programmes/p040bc43)

"In a new four-part series for BBC World Service and The Open University, broadcaster and medic Dr Kevin Fong explores what healthcare can learn from other organisations that succeed and fail. In this programme, Kevin joins a helicopter air ambulance crew in the United States and discovers how the combination of commercial pressures and de-regulation have resulted in helicopter EMS becoming one of the most dangerous occupations in the country. According the National Transport Safety Board, the body charged with investigating aircraft safety, over a twenty year period, they have averaged one accident every 40 days in the United States. Kevin hears from medical crew, pilots, regulators and survivors, to discover what needs to change in order to reduce accidents and improve safety for the hundreds of thousands of patients transported by helicopter air ambulances each year."

Posted originally from my tablet hence not able to include the summary

[Ian Corrigible]

Thanks for sharing. Interesting to see an outsider's take on our industry.

Despite the Westpac image shown on the page, the focus of the program was actually UW Med Flight (http://www.uwhealth.org/med-flight/about-med-flight/20435), with contributions from UCAN's Ira Blumen (http://em.uchicago.edu/people/name/ira-blumen).

The program did rather tippy-toe around the 'race to the bottom' (certain operators "making a killing" by paying $500,000 for 25-year old helicopters "that have been worn out in the Gulf of Mexico" but still receiving the same CMS reimbursement as an operator flying a brand new state-of-the-art aircraft), without actually mentioning Any Ems Leader... :suspect:

The claim at the end of the program that "the fatal accident rate has fallen significantly" is also debatable, depending on the metric (/denominator) used: excluding the outlier year of 2008, the absolute fatality statistic has not improved much, if at all:

http://i.imgur.com/WcyBHdz.jpg (http://www.propilotmag.com/archives/2016/Feb%2016/A1_editorial_p1.html)

I/C

[SilsoeSid]

There is something about single engine helicopters

Since 2008 we've had 20 HEMS crashes in the US, 18 of those have been single engine. Currently the industry is about 48 single engine helicopters and 52 twin. So here we have 85% of the accidents caused by 48% of the helicopters. There is some issue with single engined helicopters.

BBC World Service - The Truth About ..., Success and Failure in Medicine, The Business of Failure, There is something about single engine helicopters (http://www.bbc.co.uk/programmes/p040tq8d)

No doubt the usual suspects will have something to say about that :rolleyes: :zzz:

[[email protected]]

Standby for some blather about the stats being distorted and it not being due to engine failures so don't keep picking on singles because they are just as safe even if they do keep crashing but they could have two gearboxes and still crash and its not fair to blame singles and none of you understand its down to 10-5 probability of engine failure and no-one listens to my arguments because industry is conspiring against singles and we'd be so much safer if we all flew singles etc etc etc yadayadayada

[whoknows idont]

I'm all pro twin engine. I'm convinced that the second engine significantly improves safety.
But in this case one could argue that the operators that choose twins probably tend to having a different cost structure and better safety culture than the ones running singles. That tendency would definitely play a significant part in these overly explicit numbers.

What I took away from the BBC report was that the core issue is the profit oriented approach of US HUMS and that does make a lot of sense.
Then again, the whole situation is pretty symptomatic for the state of the US health care system...

[Heliringer]

How many accidents were from engine failures?

How many were at night in bad weather?

I fly twins and the odd single, two are better than one but Night flying in bad weather with no autopilot caused lots of these accidents I suspect. Most modern twins have Autopilot, that sort of stabilisation is very very rare in a single, maybe that's why its more singles in the accidents stats.

[krypton_john]

85% of accidents caused by the 48% SE helicopters does sound interesting...

But in how many of the SE accidents was the cause specifically related to being single engined? There's an * on 2008 as there was a mid-air in there - was that one single engined?

Without this detail, the statistic is of no use. Further, the sample is very small and possibly cherry picked.

Lies, damn lies and statistics!

If we are going to make unsubstantiated guesses about these numbers, here's mine: cut price operations using singles will also have many other safety trade-offs in addition to being single engine such as lack of maintenance support, lack of procedural control, commercial pressure and perhaps most of all they will be single pilot operating night VFR.

[AnFI]

Note Crabs post is blather with a little blither
"Standby for some blather"

Crab: Blithering blathering bampot

[[email protected]]

Hahahahahahaha!!! That is actually one of your more coherent posts AnFI:)

And you still need to visit the shops for a sense of humour:)

[[email protected]]

Heliringer - I think you have it about right.

[Thomas coupling]

Listen to the podcast guys.

"The vast majority of crashes in this industry occur at night"...
Those who do not utilise NVD's carry the brunt of the crashes,plain and simple.

Add to that the ongoing commercial pressures where there is a LOT of money to be made doing EMS in the USA and you have a recipe for COWBOYS to infiltrate the system. Usually those 'cowboys' are disgusied as business people in suits who milk the industry for millions whilst watching their coal face workers - perish!

This is not a difficult conumndrum. It is very simple, blank off one of the swiss cheese holes: commercial gain and/or poorly equipped outfits flying at night. Simples.
:ugh::ugh:

[Gomer Pylot]

Simple? Maybe for simple minds. In reality it isn't so simple. The Constitution of the US is still in force, as well as the legal system. This ain't Blighty Old. The FAA does not rule entirely by fiat, and has serious limitations on its authority. This has been pointed out repeatedly on this forum, but it seems to be continually ignored. Perhaps we should begin trying to fix all the problems of the UK. I'm sure our advice would be welcomed with open arms. Or perhaps not.

[SASless]

We have hashed this out several times over the years.

The US EMS Industry has morphed from its original days into a much different model and perhaps has seen somewhat of the early days Redux when the funding model changed and non-hospital based community based EMS Operations kicked off where cost effectiveness as an ambulance service determined success or failure.

At least with the Hospital Based system....the EMS service was seen as a way of getting patients into the Hospital for very expensive treatments and the direct cost of the EMS operation was offset by the increased Revenue for Medical Services.

It is not as simple as single vs twin engine or VFR vs IFR or Single Pilot vs Two Pilot....what we see reflected in the Stats is all of these factors.

Sometimes I think the Helicopter Industry is its own worst enemy where Competition is allowed to kill people....a gun gets bought, ammunition is put into it...it gets aimed at a Pilot's head...a finger is put on the trigger....by the Operators, FAA, and Customers....and when a Pilot shoots himself....it is the Pilot's fault and not anyone else.

[tottigol]

BlaBlaBlah, I am tired of the rethoric.
Just like SAS says, this horse has been reduced to pulp already.
There is no worse deaf than those who refuse to listen, the FAA HAS the power to make decisions to introduce legislation to affect safety of operations.
We all know what are the measures that need to be taken.
Unfortunately they sleep with the enemy.