Performance measurement in British Helicopter Emergency Medical Services and Australian Air Medical Services

Abstract

HEMS in Britain and Australian aeromedical retrieval services do not have uniform patient outcome measures. Services tend not to follow-up patients beyond 24 h post transfer. Patient outcome data are rarely presented to an external organisation and there is no formal data comparison between surveyed services. Services are not satisfied that the data currently being collected reflects the quality of their service.

Review article: Primary aeromedical retrievals in Australia: An interrogation and search for context

“…27 British HEMS and Australian HEMS in patient outcomes measures used. 2 Common outcome measures used: mortality at 24 h, RTS, REMS, SAPS-2 and adverse patient events. 2 Cost Effectiveness: Patients receiving physician intervention pre hospital, who were transported by either road or HEM termed HEMS.…”

“…2 Common outcome measures used: mortality at 24 h, RTS, REMS, SAPS-2 and adverse patient events. 2 Cost Effectiveness: Patients receiving physician intervention pre hospital, who were transported by either road or HEM termed HEMS. Physician staffed HEMS vs. ground transport or indirect transport.…”

“…11 AIS, Abbreviated Injury Score; GOS, Glasgow Outcome Scale; GSA, Greater Sydney Area; HEMS, Helicopter Emergency Medical Services; HIRT, Head Injury Retrieval Trial; ICU, intensive care unit; ISS, Injury Severity Score; NIPPV, noninvasive positive-pressure ventilation; NSW, New South Wales; REMS, Rapid Emergency Medicine Score; RTS, Revised Trauma Score; SAPS-2, Simplified Acute Physiology Score; TISS, Therapeutic Intervention Scoring System. Level II (n = 2) 22,24 Level II (n = 2) 22,24 Level III-2 (n = 3) 20,26,44 Level III-2 (n = 2) 28,41 Level III-2 (n = 1) 41 Level IV (n = 11) 12,15,16,25,[29][30][31]33,34,39,43 Level IV (n = 16) 11,13,14,[17][18][19]21,27,32,35,37,38,40,42,45 Level IV (n = 9) 2,13,21,31,35,37,45,46 Quality Reasonable (n = 5) …”

“…18,27,32,41 Aeromedical research is part of the axiom that 'data collection is often dictated by convenience and cost rather than utility'. 2 This convenience manifests in narrative bias that emerges from the resulting publications, which abstract data from case sheets. 21,25 Contrastingly, articles which examine differences between services (i.e.…”

“…1 Primary retrieval cases are often high acuity and require dynamic clinical skill application from the activated team. 2 Primary retrieval staff require a high-level autonomous competency as clinical assistance and equipment are often limited in both the field and onboard the aircraft. 1 To be effective, efficient and safe aeromedical retrieval requires the effective integration of multiple facets of patient care, clinical governance, logistics, communication and aviation safety.…”