Submitted by David Ellis, IAFCCP Board PresidentDavid_E_small

Regardless of operator, service type, geographic location, or vehicle, we all talk safety. It’s a common theme in every staff meeting, industry conference, and lecture, and we keep having preventable accidents.

We have safety day in new Employee Hire training, monthly safety meetings, and annual education events, but we keep having preventable accidents.

The FAA has increased pressure on operators to upgrade equipment, reporting systems, tracking, and safety features, and still we keep having preventable accidents.

What is the one factor that can’t be legislated, trained, or purchased to help us achieve that year we all dream of: the Vision Zero year? We have always held the belief that weather is the big killer in HEMS. But is this really the case?

In Dr. Ira Blumen’s extensive research into causes of air medical accidents, we can gain some clarity. In reviewing 150 HEMS accidents, his research team was able to provide some clarity by applying Standard Problem Statements as applicable to each accident.

The top Specific Standard Problem Statements were Aircraft position and hazards, Disregarded cues that should have led to termination of current course or action or maneuver, Failed to recognize cues to terminate course of action or maneuver, Lack of real-time data available, Pilot misjudged own limitations / capabilities, Pilot decision making, Risk Management inadequate, Inadequate and / or untimely intervention by medical crew member, Diverted attention / distraction, and Management policies / oversight inadequate.

Almost universally each of these Statements point back in one direction: individual and team decision making. The top Specific Intervention suggested by Dr. Blumen and his research team is “Air Medical Resource Management training and utilization.”

While nearly every HEMS program has some version of AMRM training in place, the quality, utilization, and enforcement varies widely. I have personally experienced everything from a program using a single one hour “AMRM” initial lecture and a once-a-year unfocused team building meeting as AMRM Training, to a program holding a multi-day AMRM initial introduction, monthly refreshers, and rigid enforcement of specific call outs, responses, and feedback to continue any given maneuver or operation. The difference between the two (and all those programs lying somewhere in between) is vast and as an industry clearly is not adequately preparing us as flight crew members to face the decisions we need to make in the course of our duties.

While the added mandatory and recommended safety and situational awareness equipment is quite helpful, we are not going to reach our goal of Vision Zero until Air Medical operators put much more emphasis on true AMRM, and until individuals truly realize the necessity of breaking out of complacency, accept responsibility as a linchpin in the safety of each and every flight, and utilize their authority and responsibility to stop any action that may create another link in the chain leading to an accident.

So what is the magic potion that will create this environment? The short answer is there isn’t one. The pathway to creating the culture within our industry necessary for Vision Zero to occur lies at the grass roots level: each individual must lead the way within their own team towards the construction of that culture. Vince Lombardi said “Leaders aren’t born, they are made.” Tom Peters is quoted as saying “Leaders don’t create followers, they create more leaders.” Be the safety Leader within your team, at your base, within your program. People will follow your lead and in turn will lead others. Cultures are not changed through policies, equipment, or legislation. They are changed by individuals – you, me, each one of us – standing up and leading the way. Be the Leader today.