26 Sep 09 NTSB Issues Recommendations On Medical Helicopter Operations

From Aero-News Network: Hersman Says They Will "Prevent Accidents And Save Lives"

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In a letter to the Secretary of Health and Human Services Kathleen Selibus, NTSB Chair Debora Hersman has offered four recommendations for the providers of medical helicopter services. The recommendations follow the investigations of recent accidents, which reached record numbers in 2008.
Hersman says in the letter that there were 12 accident involving HEMS aircraft in 2008, and that eight of those accounted for 29 fatalities. The services were the subject of an NTSB hearing in February, and the recommendations are derived in part from testimony given at those hearings. "Topics examined were flight operations procedures including flight planning, weather minimums, and preflight risk assessment, as well as safety-enhancing technology such as TAWS and NVIS. Flight recorders and associated flight operations quality assurance programs were also discussed," Hersman wrote. "Training, including use of flight simulators, was discussed at length, as well as corporate and government oversight of HEMS operations.
One of the principal issues to arise during those hearings was the matter of reimbursement. HEMS services are not covered by insurance companies unless a patient is actually transported, which Hersman says motivates the companies to transport patients to generate revenue. "The NTSB is concerned," she wrote, "that the current reimbursement strategy used by CMS (Centers for Medicare & Medicaid Services) serves as a disincentive for some HEMS operators to make capital investments or other improvements that would increase the level of transport safety provided and thereby reduce risk."
"To that end," she continued, "the NTSB believes that a CMS reimbursement structure requiring compliance with safety standards that incorporate HEMS safety recommendations issued by the NTSB since 2006 would encourage HEMS operators to increase their level of flight safety to best industry practices rather than minimum legal requirements."
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Debora Hersman

Hersman made the following recommendations on behalf of the NTSB:
  • Evaluate existing helicopter emergency medical services (HEMS) reimbursement rate structure to determine if reimbursement rates should differ according to the level of HEMS transport safety provided.
  • If the findings from that evaluation conducted reveal that higher levels of reimbursement are required to increase the level of safety, establish a new reimbursement rate structure that considers the level of helicopter emergency medical services transport safety that is required.
  • Develop minimum safety accreditation standards for helicopter emergency medical services (HEMS) operators that augment the operating standards of 14 Code of Federal Regulations Part 135 by including, for all flights with medical personnel on board, (a) scenario-based pilot training, (b) implementation of preflight risk evaluation programs, (c) formalized flight and dispatch procedures, (d) safety management systems, and (e) the installation of Federal Aviation Administration-approved terrain awareness warning systems, night vision imaging systems, flight data recording systems for monitoring, and autopilots if a second pilot is not used.
  • Once the accreditation standard requested in Safety Recommendation A-09-106 is developed, establish a policy that provides Medicare reimbursement for helicopter emergency medical services (HEMS) transportation only to those HEMS operators that meet those standards.
Hersman said the NTSB has also issued recommendations to the FAA to improve the safety of HEMS operations, including installation of the safety equipment outlined in the letter. She said the NTSB expects the FAA to enact changes in the safety requirements for HEMS operators in response to these recommendations.
FMI: www.ntsb.gov

I believe the NTSB is proposing a sound strategy here, an investment in safety that wiil raise the bar.
Fly Smart,
Kent


19 Sep 09 FAA Launches New Accident Prevention Office

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From Aero-News Network: "As part of a strategy to reduce emerging aviation risks using national safety data, the FAA's Office of Aviation Safety Thursday launched a new Accident Investigation and Prevention Service that integrates the work of the Offices of Accident Investigation and Safety Analytical Services.
“This program give us better tools to spot potential safety problems and head off aviation accidents before they happen,” said U.S. Transportation Secretary Ray LaHood.
“If we are going to continue to improve aviation safety, we have to be able to gather safety information from our industry and use data-driven safety programs to identify and address risks before they lead to accidents,” said FAA Administrator Randy Babbitt.
The new organization will consolidate resources so the FAA can better understand current and emerging risks across the aviation community through the use of data from accident and incident investigations, historical accidents and incidents, and voluntarily submitted information from industry programs such as Aviation Safety Action and Flight Operational Quality Assurance programs.
The Aviation Safety Information Analysis and Sharing program combines information from industry and government data sources to provide new insights into potential safety issues. The program has matured to the point that the FAA can now look at data from more than 73 percent of current U.S. commercial operations and identify emerging vulnerabilities and trends. Safety improvements are made not only through FAA regulations, but also through the Commercial Aviation Safety Team (CAST).
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The Accident Investigation and Prevention Service will be headed by Jay Pardee, who most recently was the director of the Office of Safety Analytical Services. Pardee is recognized as a leader in safety data analysis. He has been a leader in CAST, which won the 2008 Robert J. Collier Trophy for achieving an unprecedented level of safety in U.S. airline operations. He is also the agency’s lead to assure that the Next Generation Air Transportation System provides enhanced levels of safety. Tony Fazio, who most recently was director of the FAA's Europe, Africa and Middle East Office in Brussels, will serve as deputy director."

Editor: This is a huge step in the right direction towards a systematic approach to operational safety. This Office will be able to leverage the promise of ASIAS. It will also optimize the use of critical NASA ASRS data towards awareness and education efforts, most helpfully for the GA community, where hybrid programs of quantitative and qualitative analysis have long been needed.
En Anglais? We're going to use mishap investigation tools to prevent mishaps. That requires your input!
Fly Smart,
Kent

16 Sep 09 Concepts for Fatigue Countermeasures in Part 121 and 135 Short-Haul Operations

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SAFO Safety Alert for Operators; U.S. Department SAFO 09014 of Transportation DATE: 9/11/09; Federal Aviation Administration Flight Standards Service Washington, DC
http://www.faa.gov/other_visit/aviation_industry/airline_operators/airline_safety/safo
A SAFO contains important safety information and may include recommended action. SAFO content should be especially valuable to air carriers in meeting their statutory duty to provide service with the highest possible degree of safety in the public interest. Besides the specific action recommended in a SAFO, an alternative action may be as effective in addressing the safety issue named in the SAFO.

Subject: Concepts for Fatigue Countermeasures in Part 121 and 135 Short-Haul Operations
Purpose: To provide insights to operators and crew for mitigating fatigue in short-haul flight operations.
Discussion: Short-haul pilots commonly identify sleep deprivation and high workload as the main factors contributing to their fatigue. Conversely, long-haul pilots generally attribute sleep deprivation and circadian rhythm disruption caused by multiple time-zone crossings as the main causes of fatigue. However, both short-haul and long-haul flight crewmembers report fatigue resulting from multiple flight legs, early wake times, consecutive duty days, insufficient recovery sleep periods, time demands and high workloads resulting from high density air traffic environments. Fatigue is a hazard that if not properly mitigated or countermeasures enacted, can elevate the risk of these flight operations. Certificate holders must recognize the potential for elevated risk and be proactive in minimizing exposure to fatigue-related incidents or accidents.
Typically, short-haul (domestic) pilots are engaged in “hub and spoke” operations with some limited point-to-point flying. Short-haul crews are challenged by schedules that involve short turn-around times between multiple flights. Pilots conducting these types of operations report their schedules typically consist of four to five segments, averaging approximately six hours of flight time. Thirteen to fifteen hour duty days typify this type of operation. The result is an increased workload due to the multiple take-offs and landings and time constraints of meeting schedule deadlines over the course of the long day.
Scheduling factors have a major impact on a crewmember’s ability to sleep and maintain a proper level of alertness. Sleep loss is one of the primary contributors to fatigue in flightcrew and is directly related to a variety of scheduling factors. In short-haul operations, pilots normally fly a round trip out of a hub and then may sit for several hours before their next flight. This type of scheduling has the potential for a latent condition that contributes to the cumulative effects of fatigue.
Effective sleep opportunities are a critical countermeasure to fatigue. This should be the responsibility of both the certificate holder as well as the individual pilots. Certificate holders should consider providing crew rest facilities that have rooms away from the general traffic for quiet, comfortable and uninterrupted sleep as well as expedited transportation to and from the airport in the layover city. Individual pilots must understand the importance of sleep opportunities and ensure they are properly rested prior to the next flight day.
Recommended Action: The part 121 Directors of Operations and Safety and part 135 Directors of Operations should review their current policies and procedures addressing flight crewmember fatigue countermeasures. This review should address at minimum:
Approved by: AFS-200 OPR: AFS-220/250
Approved by: AFS-200 OPR: AFS-220/250
• Current scheduling practices;
• Scheduled or assigned rest periods;
• Establish effective rest enhancing prerequisites for layover city hotels; and
• Encourage the use of flightcrew rest facilities between flights to counter the effects of cumulative fatigue.
• Educate their pilots and crew on the importance of proper rest and encourage them to take advantage of rest facilities.
Pilots in part 121 or 135 operations should understand their responsibility with regard to ensuring that they achieve the required rest so they are properly rested and fit for each assigned or scheduled flight.
The Federal Aviation Administration (FAA) will continue to research the subject of fatigue, evaluate the relevant data and inform the commercial operations community of effective methods for reducing flightcrew fatigue.
Contact: For more information about the content of this SAFO, please contact Dale E. Roberts at the Part 121 Air Carrier Operations Branch, AFS-220 at 202-267-5749.

There are some great studies out there on how important sleep is to human performance. I'll post a few of them. Here's one found within the Federal Railroad Administration's new Confidential Close Call Reporting System (C3RS).

Sleep Smart,
Kent
Fatigue
Fatigue

ATSB article on fatigue


12 Sep 09 Runway safety tool kit released

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Posted by Janice Wood · September 11, 2009
The Flight Safety Foundation and the International Air Transport Association (IATA) recently released the Runway Excursion Risk Reduction (RERR) tool kit.
The tool kit provides an in-depth analysis of runway excursion accident data, a compilation of risk factors, and provides recommendations for operators, pilots, airports, Air Traffic Management, Air Traffic Controllers and regulators to assist in addressing this challenge, Flight Safety Foundation officials said.
“At the request of several international aviation organizations, the Flight Safety Foundation initiated a Runway Safety Initiative (RSI) to address the challenge of runway safety,” noted FSF President and CEO William Voss. “This was an international effort with participants representing the full spectrum of stakeholders from the aviation community. We wanted to reach out to the entire aviation community with the findings and working with IATA to produce a tool kit containing this information made a great deal of sense as they were one of the RSI participants.”

After reviewing all areas of runway safety over the past 14 years, the RSI group focused on runway excursions as they discovered that 97% of runway accidents were caused by excursions. They also found that over the past 14 years, there had been almost 30 excursions per year for commercial aircraft (over 25% of all accidents). The study also noted that although the percentage of excursions that included fatalities was low, the sheer number of excursions still meant that there were a high number of fatalities. Independent of the FSF effort, IATA’s Safety Group had identified runway excursions as a significant safety challenge to address.
The final report of the RSI effort, titled “Reducing the Risk of Runway Excursions,” was released in June and provides data on runway accidents, notes the high risk areas, and provides interventions. This report is included, along with other information and presentations, in the Runway Excursion Risk Reduction tool kit.
For more information: FlightSafety.org or IATA.org.

Fly Smart,
Kent



02 Sep 09 NTSB Issues New Recommendations For Helicopter EMS Safety


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From AvWebBiz: "The FAA needs to do more to regulate helicopter emergency medical services, the NTSB said on Tuesday, and operators also need to improve their training and procedures. "The pressure on HEMS operators to conduct their flights quickly in all sorts of environments makes these types of operations inherently more risky than other types of commercial flight operations," said NTSB Chairman Deborah Hersman. "Operators need to use every available safety tool to conduct these flights and to determine when the risk of flying is just too great." The board said the FAA should mandate better pilot training, improve its data collection and monitoring, develop a low-altitude airspace infrastructure, and require crews to be trained to use night-vision systems. The agency should also require the use of autopilots during single-pilot HEMS operations. Operators should work to improve pilot training and upgrade their equipment, the NTSB said.
The NTSB also made recommendations to two other agencies that are involved with HEMS -- the Centers for Medicare & Medicaid Services at the Department of Health and Human Services and the Federal Interagency Committee on Emergency Medical Systems. CMMS should consider linking Medicare reimbursements to patient transport safety standards, the board said. And FICEMS should look for better ways to integrate HEMS into local and regional emergency medical systems and ensure that in each case, the most appropriate emergency transportation mode is selected for victims of trauma. HEMS operations include an estimated 750 helicopters, 20 operators, and 60 hospital-based programs. They transport seriously ill patients and donor organs 24 hours a day in a variety of environmental conditions. For the HEMS industry, 2008 was the deadliest year on record with 12 accidents and 29 fatalities. In response to this increase in fatal accidents, the NTSB placed the issue of HEMS operations on its "Most Wanted List" of aviation safety improvements. The FAA is working on a new rule proposal that is expected to be released early next year. Click here for more details about the board's recommendations."
FMI: AvWeb
As one industry member stated, we need to keep the discussions "lively" and continue to look for innovative ways to improve safety in the HEMS community. Developing a set of Standards and Recommended Practices beyond 14 CFR is a good start. And the recent external image pdf.png HEMS_Industry_Risk_Profile.pdf published by FSF is a fantastic source document and roadmap to operational safety management.
Fly Smart,
Kent