Developing Quality Indicators for Helicopter Emergency Medical Services Coordination in Norwegian Emergency Medical Communication Centrals: A Consensus Process

The introduction of a regional Norwegian HEMS coordinator: an assessment of the effects on response times, geographical service areas and severity scores

“…Hence, appropriate resource utilization of HEMS has become an increasingly important topic in prehospital emergency research [2,[7][8][9][10][11]. The way HEMS resources within a region are dispatched and coordinated is an essential part of this and a subject for current research [12][13][14]. Due to the complexity of several contextual factors, such as perceived severity, available alternative resources, weather conditions and mission location involved in the dispatch process, evidence for the benefit of specific HEMS dispatch criteria is scarce [14,15].…”

“…In 2014, the South-Eastern Norway Regional Health Authority, as the first of Norway's four health authorities, established a regional HEMS EMCC [13,17]. Suboptimal control over HEMS flights in the region and unwanted HEMS delays for EMCCs without HEMS coordination were the main reasons for this system change.…”

“…Suboptimal control over HEMS flights in the region and unwanted HEMS delays for EMCCs without HEMS coordination were the main reasons for this system change. During the terror attack on July 22 nd in Oslo in 2011, flight-following systems (a safety measure to ensure urgent response in case of emergencies) were also found to be inadequate [13,[17][18][19]. In addition to their basic education as nurses, paramedics or emergency medical technicians, selected EMCC operators were then specially trained on different aspects of HEMS operations (including emergency medicine, rescue techniques and crew resource management principles) to staff the regional HEMS EMCC [19].…”

“…As such, adding an extra HEMS coordinator link could cause HEMS dispatch delay, which might affect patient outcome in time-critical settings. Until now, evaluations of this intervention have been limited to simply measuring the extra call delay, which was found to be 35 s on average during the first 6 months after implementation in one region [13]. Prior to the intervention, this potential delay was thought to be outweighed by improved coordination of regional HEMS resources, which could affect response times, mission distribution and alarming procedures [13,17].…”

“…Until now, evaluations of this intervention have been limited to simply measuring the extra call delay, which was found to be 35 s on average during the first 6 months after implementation in one region [13]. Prior to the intervention, this potential delay was thought to be outweighed by improved coordination of regional HEMS resources, which could affect response times, mission distribution and alarming procedures [13,17]. As with any major organizational change in critical parts of the emergency medical services (EMS) [23], this intervention should therefore be more thoroughly evaluated.…”