Sikorsky S76s save kids at Arkansas Children’s Hospital

Dedicated HEMS operation uses integrated SMS and FAA-approved FOQA program to provide safe patient transport to advanced care facility.

(L–R) Program Dir Steve Haemmerle, VP Patient Care Services Mary McDaniel, Dir of Aviation Maintenance Mike Dwyer and Dir of Aviation Operations B J Raysor.

Beyond hard safeguards, such as technology and equipment, the most important aspect of transporting patients safely is the proper mindset and decision-making of pilots. Raysor says, “Clinical crew­members will manage patient care.

Patient condition will never influence aviation decision-making. The hospital and FAA expect us to leave our emotions aside. This is one of the toughest, but most important, challenges of an Angel One pilot.” Apart from FAA and NTSB, organizations such as the Intl Helicopter Safety Team (IHST) have recommended other widely accepted industry best practices to improve flight safety.

Two programs are SMS and helicopter flight data monitoring (HFDM). Until now, the perception was that implementation of SMS and HFDM was a challenge to small operators based on limited resources. Typically, these challenges or barriers can be categorized as either organizational or technological.

ACH tackled each issue by outsourcing certain organizational functions and leveraging technology, such as Web-based applications and lightweight flight data recorders, to better facilitate these programs.

SMS and FDM for the small operator

Last year, ACH contracted Baldwin Aviation to add SMSPlus—a Web-based portal—to enhance and support the growth of its SMS. Raysor says, “Our movement to SMS evolved from a search for a more efficient and responsive mission debriefing process to improve communications of minor operational concerns.

We were catching significant safety issues through hazard reporting and root cause analysis, but it was post-event in a lot of cases. We wanted to be more proactive with eventual trend identification.”

Raysor is active with industry working groups and is a member of IHST. One hurdle identified by IHST is the difficulty for smaller operators due to limited infrastructure to implement programs such as SMS. Raysor says, “Baldwin provided us the tool we needed to achieve our desired outcome while overcoming cost and staffing concerns.”

In Sep 2009, ACH received FAA approval of its FOQA program. In the US, FOQA is a term used to describe an FAA-approved FDM program. To date, this is the only FAA-approved program by a dedicated HEMS operation. ACH has demonstrated that a small operator can have an effective HFDM program through use of advanced technologies and third-party services.

According to Raysor, “There were several key components of our success with FOQA/HFDM. We decided to contract a third-party data analysis company—CAPACG—based on their experience with the Bristow Group and other fixed-wing safety programs to develop the ACH FOQA implementation and operations plan. CAPACG was retained to provide the analysis and reporting functions of the program.

This relationship added a level of anonymity to our FOQA program.” Raysor adds, “Senior management and all the pilots pulled together [in implementing FOQA]. The safety enhancement and data protection portion of the FAA-approved program was a strong selling point to us as an operator, the pilots and especially appealing to our aviation insurance brokers and underwriters.”

FOQA affects an operation in several categories including economics, maintenance, operational, safety and training. Realizing these benefits, Raysor says, “We have already used FOQA data during an autopilot excursion in IFR conditions to en­hance our root cause of validating the pilot’s experience with the incident and applying lessons learned to our training program.

After this event, we were able to avoid expensive and unnecessary maintenance inspections and repairs to the aircraft prior to returning it to service directly due to the extensive data that was available post incident.

Recently we were able to effectively manage a noise complaint in our area of operations through a special case study utilizing FOQA data and the analysis services of CAPACG.” The next step for these programs is to finish developing a specific aviation safety manager/pilot position to take over the SMS, HFDM/ FOQA and associated training from the aviation director and chief pilot positions.

Flying for ACH

ACH follows CAMTS pilot experience guidelines as the minimum for new-hire pilots. An ATP is preferred, but some pilots have been hired with only a commercial rating. The past 3 new-hires had between 2100 and 7000 hrs of flight time. (The lower time individual had a unique skill set with a safety, training and education background.)

Raysor says, “We want to see some complex and significant IFR time in the lower time applicants that leads us to believe that they have some experience in complex, demanding cockpit task management.”

A major factor in selection is a commitment to safety and strong people skills such as a firm but tactful communication style. Currently, ACH employs 8 full-time line captains—a 50/50 mix of military and civilian trained pilots. Pilot schedules are 7 days on/7 days off, working 12-hr shifts.

Dir of Aviation Ops B J Raysor is also current in the S76. Here he prepares an aircraft for flight.

Once a new-hire pilot completes initial aircraft training at FlightSafety Intl (FSI), they return to Little Rock for 90–120 days of mission training with a company chief pilot or check airman. This training focuses on single-pilot IFR skills, safety culture and aeronautical decision-making.

To get a pilot up to ACH standards, Raysor states, takes about 6 months of training and over $100,000. Recurrent pilot training uses computer-based and classroom instruction, simulator training at FSI and aircraft check rides administered by the hospital and FAA. Dir of Maintenance Mike Dwyer and a team of 5 technicians perform all major scheduled inspections, routine maintenance, daily preflight inspections, quality control procedures and manage a parts inventory.

Dwyer’s maintenance career in­cludes service as an US Army crew chief on a Special Ops Sikorsky UH­60, an international Sikorsky tech rep and a base maintenance manager for another HEMS operator. To be considered for employment, an A&P has to have at least 5 years of relevant experience.

Half of ACH’s maintenance staff has achieved FSI master technician certification and 4 have FAA inspection authorization licenses. Dwyer’s extensive maintenance manager training has paid off, as his group accomplishes high reliability rates and low cost by establishing an extensive ongoing training program, careful parts inventory management and detailed maintenance forecasting.

Angel One’s future

According to Raysor, Angel One’s goals are to continue to enhance and evolve the SMS and HFDM/ FOQA programs and increase the integration of the 2 programs. He says, “Over the next 3–4 years, the addition of the aviation safety/pilot position and the development of a night vision goggle (NVG) program will coincide with the fleet renewal program.

One of the keys to our success is always searching for improvements to accomplish the mission, whether it is safety, efficiency or economics.” Even as the hospital continues to advance the level of pediatric care in the region, the air medical industry can look at Raysor and his Angel One unit as a highly professional flight operations organization that instills safety as a core value.

Stuart Lau is a consultant and member of IHST and the Global HFDM Steering Group. He is also a pilot for a large international airline and a safety committee member. Lau has been associated with Pro Pilot since 1996, specializing in flight safety and operations.


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