2009 - 2012 In memory of Dr John Boden. A life dedicated to - - PowerPoint PPT Presentation

A demographic review: Aeromedical Services

2009 - 2012

In memory of Dr John Boden. A life dedicated to Prehospital EMS

HISTORY

• 4 May: First Helicopter flight

request Gauteng

• 5 May: First mission

May 2009

• First Fixed Wing Charter

flight

Dec 2009

• Cape Helicopter launched
• 14 March: First mission

February 2010

FLEET

RW Gauteng

• Long Ranger

L4

• HALO

Aviation RW Cape Town

• BO105
• Base 4

Aviation FW (Turboprop)

• King Air 90

and 200

• HALO

Aviation FW (Jet)

• Falcon 20
• AMI/

Allegiance Air

PROCESS

Call received Contact Centre MO Auth process 5 minute auth to airborne (Helicopter) 1.5 hour fixed wing auth to airborne (local flights) Cape Town: Flight crew decision 3 min take off Patient flight screening by MO prior to take off

CALL VOLUMES ORIGIN

CALL VOLUMES ORIGIN CALL VOLUME AS A PERCENTAGE OF TOTAL FLIGHT VOLUME 2010 - 2012 RW - Primary RW - IHT FW - Primary FW - IHT Total Eastern Cape 2.2 0.5 0.1 0.9 3.8 Free State 1.5 1.2 0.3 1.0 3.9 Gauteng 26.4 3.6 0.1 2.0 32.1 Kwa Zulu 1.7 1.5 0.0 1.8 5.0 Limpopo 1.3 2.0 0.1 0.2 3.6 Mpumulanga 3.1 3.3 0.0 0.5 7.0 Northern Cape 1.0 0.6 0.1 4.1 5.8 North West 5.5 1.0 0.1 0.8 7.4 Western Cape 14.6 3.8 0.1 2.8 21.3 Africa 0.1 0.3 0.4 8.7 9.4 World 0.0 0.0 0.0 0.8 0.8 57.4 17.9 1.2 23.6 100.0

CALL VOLUMES HELICOPTER CALL VOLUME Year Flights serviced 2009 77 2010 222 2011 320 2012 61 Flights vs ER24 world

2007 0.23% 2008 0.32% 2009 0.28% 2010 0.28% 2011 0.39% 2012 0.24% Average 0.32%

DECLINED CALLS

Busy 1% Cost 8% Daylight 6% Declined by Assist. 7% Dedicated Standby 0% Distance 2% Equipment 1% Maintenance 2% No doctor 0% Other SP activated 19% Outside flight criteria 49%

• Prov. Auth

2% Weather 3%

Reasons for declined flights 2010 - 2012

AIR MEDICAL DESPATCH GUIDELINES

• South African Industry criteria
• Based on Air Medical Services Committee National Association
• f EMS Physicians
• Consider logistical and clinical picture

80% cases found to be valid flight on retrospective independent audit

CASE LOAD MIX

Indigent 16% Medical Aid/ Govt Auth 58% Private 8% WCA 18%

Funder 2010 - 2012

FIXED WING OPERATIONS

• Mostly non core business beyond South Africa
• 40% calls outsourced to local service providers (AMS,

Aerocare, Aldersons)

• Existing local client base from contracted schemes, very

small African client base

• Most patients are between 40 and 50 years old

Medical 57% Obgyn 1% Neonate 3% Trauma 39%

Fixed Wing Clinical Categories 2010 - 2012

CLINICAL GOVERNANCE

• Review includes panel of doctors/ external audit
• Retrospective and Prospective components
• Clinical Audit
• Patient follow up
• Morbidity and Mortality
• Logistical data: response times, distance, hospital

network

• Clinical recording accounted for 52% external audit concerns
• 9% Audit rejection (key areas: Ventilation, Immobilisation, poor

clinical notes)

• 4 Sentinel events to date

KEY CHALLENGES

• Cost containment and clinical excellence
• Doctor based fixed wing service beyond South Africa
• B Tech for rotor wing appears to address airway management

concerns

• Crew based helicopter flight authorisation triage with 3

criteria: Distance (10km), logistics, mechanism

• Scene based clinical medical officer authorisation for flight
• International and local aviation related delays (clearances,

port health, take off procedures)

Any Questions ?

Dr Robyn Holgate. CMO, ER24. +27 (0) 83 454 1638 For all medical emergencies call 084 124 (local) +27102053052 (International)