Time as a perishable commodity in aeromedical retrieval
Paul Bailey
Medical Director @WestCoastAeromedical; Clinician/Logistician - Medical Retrieval Consultant @CareFlight Medical Coordinator @WACHS I provide care to patients with complex clinical or logistics needs.
I coordinate the tasking of aeromedical transfers in two separate Australian jurisdictions.
I've recently come to a deeper understanding of the nature of the ticking clock as an important component of every shift. It's easy to understand that there are groups of patients for whom transport is time urgent, they are our sickest / most injured patients who find themselves far away from the care that they need.
Less obvious, however, is the insidious nature of the ticking clock and how that impacts on the capability of the transport network through a shift.
Each aeromedical and road asset has a circle of potential influence at the start of the shift that progressively degrades throughout the shift. In an idea world those spheres of influence overlap, at least to a degree and reach their maximal (and minimal) sizes at different times
The zone of influence = size and shape of the bubble; and can vary based on:
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There are many less obvious issues that also impact on the size of the zone of influence: - from the availability of refuellers to airframe maintenance to flight team fatigue rulings.
But of all of these, the most important is time, and amazingly the most stressful periods are the quiet time - sometimes several hours long, when time is passing and no meaningful clinical activity is occurring. Potential spheres of influence are shrinking. And we wait.
I'll say it once again - there are ideal scenarios and then there's being a team player in a tough game. I choose the latter.
My name is Paul Bailey, thanks for reading! I manage risk for a living. I used to be the Medical Director of the largest ambulance service in the world. In another life I was a jellyfish hunter. These days I provide aeromedical coordination services in two Australian jurisdictions. Like or comment on this post if you found it interesting, follow me on Twitter @waambedic, or drop me an InMail if you want to continue the conversation.
Leading change from traditional ILS to enhanced Integrated Product Support (IPS) and Training
5 个月Excellent article Paul. Your proposed zone of influence criteria are sound and belong in a principle-based Aeromedical Capability Framework. That's what missing nationally and by jurisdiction. It's something in which, based on our geography and demographics, Australia should be the global leader.
Registered Paramedic interested in system improvement and technology | AICGM, MACPara
5 个月It’s an interesting one isn’t it PB. There’s the opportunity cost of using your assets early to get lower acuity patients moving to help clear the stack but then not having one where you need it later for that high acuity patient because it’s already out of region or used too many duty hours. It will be interesting to see what if anything is taken from the Kennedy inquiry as a tangible addition or change to the network which helps with some of these challenges.
Aeromedical evacuation and deployable health consultant. Fellow of the Faculty of Remote, Rural and Humanitarian Healthcare, Royal College of Surgeons Edinburgh.
5 个月Great article Paul. Early notification and activation is key to maximising capability and impact in a duty period. education on what critical factors influence the capability and availability (especially duty time of aircrew) to regional clinicians and non aeromedical tasking groups like employers or insurers can help. But the people in that cohort is forever changing so the information is repeatedly lost.
Principal Project Officer
5 个月Where is the 'vortex ' ?