When an agency places a new vehicle in service, it is imperative that personnel train on that vehicle's hazards, safety features and proper equipment storage
My HEMS service just received a new EC145 helicopter. Prior to taking delivery, our department operated a Bell 222 that was built in the 1980s. Don't get me wrong, there was nothing wrong with the 222 from an operational or safety perspective. Helicopters, like cars, are discontinued as new ones are developed. Since no more 222s are being built, it had become too difficult to ensure a safe and continuous supply of replacement parts for ongoing maintenance.
Transitioning from a Bell 222 to an EC145 is like going from a 1980 Buick Regal to a 2010 hybrid SUV. Management recognized that this posed a serious change for the pilots, mechanics and medical crew and knew there would be a very steep learning curve for everyone. To help make the change, in the fall our service shifted to a BK-117, which is similar to the EC145 in many respects, providing us a stepping stone during our transition. One of the first things we realized is that we had thousands more questions and unknowns than we ever fathomed, and learning didn't take place over a period of days or weeks, but rather months. As we learned, we developed many strategies to help everyone understand the changes. Some of the strategies included:
- Having conversations with pilots, mechanics and medical crews at other programs already using the BK-117 and EC145.
- Taking photographs and creating a PowerPoint presentation showing the placement of all equipment and supplies inside the BK-117 and EC145.
- Charging one of our pilots with developing a weekly e-mail blog to identify the "lessons learned," which was shared with everyone.
- Developing a competency checklist for use by safety officers to ensure everyone had a minimum baseline knowledge about the helicopter-specific operations.
- Utilizing a simulator for the medical crew to practice inside the new patient care space, improve familiarity with equipment location, and gain some comfort with the new vehicle.
- Sharing the simulator with regional hospitals, fire and EMS services so they could gain familiarity with our new operational space.
- Having classroom and hands-on education provided by a company representative for all crew members on the vehicle's features and operations.
- Announcing publicly that our new helicopter would not go into service until all of our pilots and medical crew were properly trained in its operation.
As I discussed this one evening with a colleague who is also involved in EMS, education and writing, he said that his ground ambulance service had just received a new ambulance--"one of those big ones all the fire departments have." Being the fairly inquisitive and rather logical individual he is, he decided to take this vehicle he had never been in for a drive on his last shift. When he got back, one of his coworkers asked, "Did they show you how to drop the back yet?" Needless to say, there was some confusion.
What struck the two of us was how much effort went into educating everyone on the features, changes and safety differences for one EMS vehicle, and it was completely missing for another. I won't pretend for a moment that our department did everything perfectly for our learning curve--nobody ever does. It is a learning curve!
There are many different types of ambulances, and individual programs often have multiple sizes of ambulances from different manufacturers. In a quick nonscientific poll of some of my friends across the industry, I found one consistent and disconcerting fact: While fire departments require vehicle-specific training for every single engine, rescue truck, ladder truck, tanker, etc., it seems a driver's license is often all that is needed to operate an ambulance. Nearly every program requires CEVO or EVOC, but even these courses are quite general. As the EMS industry grows, the need for developing and emphasizing a culture of safety needs to become ever more prevalent. Part of developing a culture of safety is emphasizing safety in training.