Health Quality Council of Alberta releases findings and recommendations related to its review of the safety implications for patients requiring medevac services to and from the Edmonton International Airport

EDMONTON, May 5 /CNW/ - The Health Quality Council of Alberta (HQCA) today released findings and recommendations related to an assessment of patient safety issues to be addressed if or when medevac services are relocated to the Edmonton International Airport. The Minister of Health and Wellness, following a request by the Premier, called for the review on October 20, 2010 in accordance with Section 13 of the Health Quality Council of Alberta Regulation 130/2006 under the Regional Health Authorities Act.

"The HQCA review resulted in 18 recommendations that were developed by a highly experienced team following a thorough process. We believe implementing the recommendations will result in a safer health system not only for citizens in the Edmonton area but for all Albertans and our neighbours to the North," said HQCA Chief Executive Officer Dr. John Cowell. "The recommendations identify patient safety issues associated with the partial closure of the Edmonton City Centre Airport that need to be addressed as well as issues that should be addressed prior to the full closure of the Edmonton City Centre Airport."

The methodology included a review of previous reports about medevac transportation into the Edmonton City Centre Airport, a systematic literature search, surveys sent to identified stakeholders, a review of documents from key stakeholders, interviews with key stakeholders, a Proactive Risk Assessment (modified Healthcare Failure Mode and Effects Analysis®), observation of the medevac work environment at the two Edmonton airports and collection of data from other provinces/territories and one U.S. city.

Recommendations

  1. A Transition Advisory Committee be struck to facilitate information sharing and to advise on key decisions. Representation on this committee should include individuals from Transport Canada, NAV CANADA, Alberta Health and Wellness, Alberta Health Services, the medical community, fixed wing and rotary wing providers (both air and medical crews), the Edmonton Regional Airports Authority and a member of the public. As well, correspondence and consultation with Alberta Finance, Alberta Transportation, British Columbia, City of Edmonton, Northwest Territories, Saskatchewan and Yukon should occur.
  2. Until a new dedicated medevac facility is in place, the Edmonton International Airport must provide a dedicated area for medevac flights, which should include parking for medevac aircraft and ambulances, power, refueling and other services.
  3. Traffic patterns be studied and an optimal ambulance route established from the Edmonton International Airport to tertiary care facilities.
  4. An evaluation be conducted on the impact of traffic lights on transport times and changes implemented to minimize this impact. Changes could include installing an Optacom device/system to allow ambulances to change traffic lights to green or synchronizing traffic lights on the main routes from the Edmonton International Airport to tertiary care facilities.
  5. All ambulances be equipped with a Global Positioning System so alternate routes can be determined when traffic is problematic.
  6. The current process of how medical crews return to the airport from the tertiary care centre be improved. This could include timely transfer of care from the medevac crew to the tertiary care facility, providing taxi-cab drivers with greater financial incentive to take staff to the Edmonton International Airport or using Alberta Health Services transportation.
  7. Arriving and departing medevac flights be given priority for landing, taxi and take-off.
  8. A new facility dedicated to medevac aircraft and ground facilities be built at the Edmonton International Airport. This should include space to accommodate:
    • the transfer of patients from air to ground ambulance that is out of the elements
    • crew facilities to allow uninterrupted rest periods for flight crews
    • storage of necessary equipment
  9. The new facility/air ambulance hangar be located away from the general commercial traffic.
  10. Additional road infrastructure, such as an on/off ramp from the new facility that will provide faster access to north-bound Queen Elizabeth II or a dedicated emergency lane on Queen Elizabeth II, be built.
  11. A standardized and agreed upon coding system is implemented for classifying and prioritizing patient transports, along with standardized use of the term 'medevac'.
  12. The mandatory use of RAAPID (Referral, Access, Advice, Placement, Information and Destination) for all patient transports and the Red Referral process for all critically-ill patient transports originating within and outside Alberta be adopted.
  13. Ground ambulances that transport patients between the Edmonton International Airport and Edmonton hospitals are staffed with a second healthcare provider to provide care during ground transportation of unstable or critically-ill patients.
  14. Equipment is standardized across the various ground and air ambulance providers (including fixed wing and rotary wing).
  15. Medical personnel who transport patients in ground ambulance, rotary or fixed wing aircraft are cross trained in all modes of transport.
  16. Once equipment is standardized and personnel are trained, rotary wing transportation between the Edmonton International Airport and the tertiary care facility be used when it is deemed that this mode of transport will result in substantial time savings (e.g., extreme traffic/road conditions that would result in unacceptable delays using ground transportation).
  17. An evaluation of the entire process of the transfer of medevac patients, with application of quality improvement techniques, should be conducted to identify:
    • opportunities to reduce times spent before air ambulance transportation
    • improved and/or new ways of providing care, such as assessment of services available in hospitals outside and within Edmonton
  18. Another airport be considered as a back up within the Edmonton area with instrument landing system capabilities that can accommodate medevac flights.

"The report has been delivered to the Minister of Alberta Health and Wellness," adds Cowell. "We believe early action on Recommendation #1 to form a multi-stakeholder transition committee is vital. It would also be our expectation that each of the stakeholders would examine the 18 recommendations and take appropriate action as relevant within their area of responsibility."

As an independent organization legislated under the Regional Health Authorities Act, the Health Quality Council of Alberta gathers and analyzes information and collaborates with Alberta Health Services, Alberta Health and Wellness, health professions and other stakeholders to translate that knowledge into practical improvements to health service quality and patient safety in the health care system.

The report is available at www.hqca.ca.

SOURCE Health Quality Council of Alberta

For further information:

Pam Brandt
Health Quality Council of Alberta
403.850.5067
pam.brandt@hqca.ca

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