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Risk Assessment In The Comm Center?


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Poll: Risk Assessment in the Comm Center? (5 member(s) have cast votes)

Do you currently use a Risk Assessment Tool specific to your Communication Center Risk?

  1. Yes (2 votes [40.00%])

    Percentage of vote: 40.00%

  2. No (3 votes [60.00%])

    Percentage of vote: 60.00%

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#1 Jen

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Posted 03 December 2009 - 12:20 AM

We are in the process of implementing a Risk Assessment Tool for our Communication Center and I am wondering if anyone else is, or is in the process of using a Risk Assessment tool for Communication Center staff.
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#2 flingwing1

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Posted 03 December 2009 - 02:15 AM

We are in the process of implementing a Risk Assessment Tool for our Communication Center and I am wondering if anyone else is, or is in the process of using a Risk Assessment tool for Communication Center staff.

I am not quite sure what you are trying to accomplish. Do you want a risk matrix for the comms center to decide if a flight should go or not, a ground transport? What, exactly are you looking for.
If you are trying to give the comms center some say in whether a flight goes or not, I feel that you are going in the wrong direction. A comms center can be helpful in getting information for a flight crew and monitoring weather conditions while a flight is in progress, but that should be the extent of their involvement. The PIC says yes or no. If it is no the flight is done. If the PIC says yes but a crew member feels uncertain then the flight does not go. That is all there should be.
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#3 Macgyver

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Posted 03 December 2009 - 04:45 AM

If you are trying to give the comms center some say in whether a flight goes or not, I feel that you are going in the wrong direction. A comms center can be helpful in getting information for a flight crew and monitoring weather conditions while a flight is in progress, but that should be the extent of their involvement. The PIC says yes or no. If it is no the flight is done. If the PIC says yes but a crew member feels uncertain then the flight does not go. That is all there should be.


I am assuming you meant to say that if the pilot says no then the flight doesn't go.... That aside, I disagree. Not only is this the way that the NTSB / FAA is likely to head, it is also being pushed by NAACS. The merits of that is a whole 'nother thread...

Granted what the feds are thinking is more along the line of having a 'dispatcher' (think 121 ops / operational control) in the coms center or a pilot. PHI I think already does this. However I do see some utility in having the dispatch center do a prescreen of calls to eliminate the obvious NO's. This will save wear and tear on the pilots and med crews by only notifying them of potential responses and removing all the bogus ones. Think of it as a proactive fatigue management strategy.

Kind of what a dispatch center is supposed to do in my opinion. It also lets the dispatcher do all the confirmation calls to neighboring services when the situation is suspect (to prevent helicopter shopping) although I doubt many Program Managers will allow their dispatch centers to automatically screen out obvious "shopping" calls - call volume is still a higher priority than safety...

Take a look at the Reach HEMS dispatch matrix - once the conditions and crew status are fed into it when the threshold is reached the flight is not assigned. REACH risk assessment tool
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#4 flingwing1

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Posted 04 December 2009 - 03:16 AM

I am assuming you meant to say that if the pilot says no then the flight doesn't go.... That aside, I disagree. Not only is this the way that the NTSB / FAA is likely to head, it is also being pushed by NAACS. The merits of that is a whole 'nother thread...

Granted what the feds are thinking is more along the line of having a 'dispatcher' (think 121 ops / operational control) in the coms center or a pilot. PHI I think already does this. However I do see some utility in having the dispatch center do a prescreen of calls to eliminate the obvious NO's. This will save wear and tear on the pilots and med crews by only notifying them of potential responses and removing all the bogus ones. Think of it as a proactive fatigue management strategy.

Kind of what a dispatch center is supposed to do in my opinion. It also lets the dispatcher do all the confirmation calls to neighboring services when the situation is suspect (to prevent helicopter shopping) although I doubt many Program Managers will allow their dispatch centers to automatically screen out obvious "shopping" calls - call volume is still a higher priority than safety...

Take a look at the Reach HEMS dispatch matrix - once the conditions and crew status are fed into it when the threshold is reached the flight is not assigned. REACH risk assessment tool


You use the term dispatcher freely. I don't know your program's situation but the folks in our comms center are not dispatchers. They are communicators. My company has an ops center that exercises operational control. They are who I get my flight release through. Comms specialists, for the most part, are not trained, equipped, or expected to weed out calls. That is the job of the PIC. If we were to carry this out to it's logical conclusion we could include all of the management folks in the chain. I am not saying comms folks have no role in this situation. I seek and highly value their input. I have had them call me on things I have missed on the weather. I respect their input, however, they do not, and in my humble opinion, should not have the authority to turn down flight requests.
I have accepted flights and had a medical crew member say no. At that point the flight is over. the crewmember has the right to say no, and, except in rare circumstances, the flight is terminated and we go home, or don't ever leave. I will defend this position all day. I will, however, argue against extending the authority to those who are not in the proper position to exercise it.
That being said, the customer, to some degree, sets the rules. The hospital I fly at has decided to set their minimums higher then the ones set by the company I work for. I follow the hospital minimums when I am flying for them. When I am flying for the company (ie. training, ferry, maintenance, etc.) I use the company minimums. In other words, if the hospital (customer) says that comms has the right to turn down a flight I will abide by that decision. I will, however, try to change the policy.
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#5 Wally

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Posted 04 December 2009 - 01:55 PM

121 Dispatchers are trained and certified as such. They operate in an environment where the system integrates and supports that training and experience- Does the operation and equipment proposed meet requirements for dispatch at the proposed time to a definite destination?
In our world, it's "someplace, sometime, to somewhere else"- all indefinite until the request. EMS isn't operating to and from points with formal weather observation capability, that's a part of the structure you want to adapt and impose. A 'dispatcher'/com spec's forwarding of the request at that point IS management approval of the operation.
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#6 Jen

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Posted 05 December 2009 - 12:40 AM

I am not quite sure what you are trying to accomplish. Do you want a risk matrix for the comms center to decide if a flight should go or not, a ground transport? What, exactly are you looking for.
If you are trying to give the comms center some say in whether a flight goes or not, I feel that you are going in the wrong direction. A comms center can be helpful in getting information for a flight crew and monitoring weather conditions while a flight is in progress, but that should be the extent of their involvement. The PIC says yes or no. If it is no the flight is done. If the PIC says yes but a crew member feels uncertain then the flight does not go. That is all there should be.



Reply: No, not a risk assessment tool that would apply to aviation decision-making, clearly that lies with Operational Control and the PIC. I am speaking of a Risk Assessment Tool that would evaluate the potential risk for the communication center-specific roles and responsibilities. For example, fatigue, prolonged shift exposure, CSs within a certain training segment, staffing mixtures, etc. I am attempting to develop a tool that applies specifically to the communication center staff. For example, a score greater than X would trigger the Director's evaluation/participation, or for further example, a score greater than X would indicate the need to eliminate all non-essential distractions from the communication center environment. Current Risk assessment tools apply to the acceptance of a mission, but what risk factors affect the efficient, competent, and exacting functions of the communication specialist?
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#7 nursemedic

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Posted 05 December 2009 - 04:15 AM

Reply: No, not a risk assessment tool that would apply to aviation decision-making, clearly that lies with Operational Control and the PIC. I am speaking of a Risk Assessment Tool that would evaluate the potential risk for the communication center-specific roles and responsibilities. For example, fatigue, prolonged shift exposure, CSs within a certain training segment, staffing mixtures, etc. I am attempting to develop a tool that applies specifically to the communication center staff. For example, a score greater than X would trigger the Director's evaluation/participation, or for further example, a score greater than X would indicate the need to eliminate all non-essential distractions from the communication center environment. Current Risk assessment tools apply to the acceptance of a mission, but what risk factors affect the efficient, competent, and exacting functions of the communication specialist?



I appreciate the many distractions that exist in a communications center but I fail to see any real risk involved, except the risk to crew members if the comm spec isn't on their game--is that what you're referring to? How often would you be assessing risk...with every phone call? at the beginning of a shift? every four hours? Are you working 12-hour shifts? Do employee's drive hours to work? In my experience, all non-essential distraction should be eliminated anyway because, as you have said, it's non-essential...plus one never knows when a real emergency will occur requiring your full attention -and then who has time to go around and minimize distractions? Non-essential distractions may cause one to miss something important anyway. The responsibility of a CS is typically so variable and broad that I think any sort of assessment tool would be inherently inexact and might lead to a false sense of well being. In the end, the only thing one can do is control their own environment:

1. comfort (office temperature, proper ergonomics, lighting control),
2. hydration/nutrition
3. elimination needs
4. occasional 15 minute respite away from the activity

I understand your concern (I think) but I'm not sure there's a valid tool (having the TV on soothes me but is just noise to you). I suspect CSs in general know when to call for reinforcement or when they need a time out. The biggest risk I see is job complacency and responsibility of identifying-and reporting-that falls to the individual, their peers, and manager to call out complacency when it occurs.
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Greg

#8 nws2002

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Posted 08 December 2009 - 04:32 AM

I could see completing a one-time or periodic (annually or quarterly) as part of an overall Safety Management System, but I too am not sure I see the value of doing on every shift or every call.

If you are worried about fatigue and scheduling issues specifically, you should have a look at the recommendations outlined by the Air Medical Safety Advisory Council (AMSAC).
http://www.amsac.org...r_comm-spec.htm
We use their guidelines, with some tweaks, as our scheduling policy.

As the comm supervisor I also, call in at least once per shift to check in. I think this is a big help and I try to vary the time of the call so sometimes its at the start, sometimes mid-shift, and sometimes towards the end.

As for the dispatcher vs comm spec argument. I feel that having a part 121 style dispatcher could potentially enhance safety within the vast majority of air ambulance operations. I'm also sure that current comm specs don't have the training or experience necessary. Though, sending them all to airline dispatcher school will not give them the skills needed. So, where does that leave us? The NAACS operational control course is a good step, not perfect, but a good step. I just like the formalized, second set of eyes signing off on all flights.
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#9 Jen

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Posted 09 December 2009 - 12:29 AM

I could see completing a one-time or periodic (annually or quarterly) as part of an overall Safety Management System, but I too am not sure I see the value of doing on every shift or every call.

If you are worried about fatigue and scheduling issues specifically, you should have a look at the recommendations outlined by the Air Medical Safety Advisory Council (AMSAC).
http://www.amsac.org...r_comm-spec.htm
We use their guidelines, with some tweaks, as our scheduling policy.

As the comm supervisor I also, call in at least once per shift to check in. I think this is a big help and I try to vary the time of the call so sometimes its at the start, sometimes mid-shift, and sometimes towards the end.

As for the dispatcher vs comm spec argument. I feel that having a part 121 style dispatcher could potentially enhance safety within the vast majority of air ambulance operations. I'm also sure that current comm specs don't have the training or experience necessary. Though, sending them all to airline dispatcher school will not give them the skills needed. So, where does that leave us? The NAACS operational control course is a good step, not perfect, but a good step. I just like the formalized, second set of eyes signing off on all flights.



Reply: Thank you everyone for the great dialogue and thank you for the reference to the AMSAC recommendations. We currently are completing a Risk Assessment specifically designed for the CS every shift change (minimum q 12 hrs.) I do believe that the risks (human factors/staffing/workload etc. )associated with CS performance are real and that a more structured approach to "checking in" is required...in our Comm Center anyway. As I mentioned previously, a certain Risk value triggers notification of the Director who then assesses the staffing/environment/etc. Similar to how fatigue policies have evolved within the medical and aviaiton arena, so, I believe should we be evolving within our communication centers. Very interesting though....how best to proceed? Great conversation topic...thank you all for sharing your thoughts...
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#10 nws2002

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Posted 10 December 2009 - 06:38 AM

Very interesting though....how best to proceed? Great conversation topic...thank you all for sharing your thoughts...


Would you mind sharing some of the criteria and grading scale you use for the com ctr risk assessment? I'm not opposed to a more structured approach, its just something that I've never really considered.

This is veering off topic a bit, but the FAA limits Part 121 dispatchers to a 10 hour duty day. While our operational environments are very different, our positions require similar levels of concentration, and both can be stressful at times. Does anyone know what kind of shift briefings and risk assessments they conduct in Part 121 operations? I'm considering contacting a few of the airlines to see what they do.
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#11 Jen

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Posted 11 December 2009 - 12:00 AM

Would you mind sharing some of the criteria and grading scale you use for the com ctr risk assessment? I'm not opposed to a more structured approach, its just something that I've never really considered.

This is veering off topic a bit, but the FAA limits Part 121 dispatchers to a 10 hour duty day. While our operational environments are very different, our positions require similar levels of concentration, and both can be stressful at times. Does anyone know what kind of shift briefings and risk assessments they conduct in Part 121 operations? I'm considering contacting a few of the airlines to see what they do.


Reply: Sure, We have incorporated factors as they apply to 1) Staffing and 2) Fatigue/Human Factors. In the Staffing section,some examples are CS experience in the room, CS in training or recently released from training, first four-week schedule rotation change(day/noc/swing) ,CS called in to cover a shift or on extended hours etc. and in human factors area such criteria as 4th or greater consecutive shift, < 8hrs rest, SX of illness, EAP drill or actual during shift rotation week etc. We have just tried to incorporate factors that may affect the CS function. As I mentioned somewhere along this chain, work-load/flight activity automatically elevates the Risk Score at anytime during the shift.
I don't think I want to throw out the scoring process as we are still experimenting with this entire tool.
I am intrigued by your thought to contact a Part 121 operator to see what they do....please let us know...thanx...Jen
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#12 nws2002

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Posted 03 March 2010 - 08:27 PM

Reply: Sure, We have incorporated factors as they apply to 1) Staffing and 2) Fatigue/Human Factors. In the Staffing section,some examples are CS experience in the room, CS in training or recently released from training, first four-week schedule rotation change(day/noc/swing) ,CS called in to cover a shift or on extended hours etc. and in human factors area such criteria as 4th or greater consecutive shift, < 8hrs rest, SX of illness, EAP drill or actual during shift rotation week etc. We have just tried to incorporate factors that may affect the CS function. As I mentioned somewhere along this chain, work-load/flight activity automatically elevates the Risk Score at anytime during the shift.
I don't think I want to throw out the scoring process as we are still experimenting with this entire tool.
I am intrigued by your thought to contact a Part 121 operator to see what they do....please let us know...thanx...Jen



Contacted a few airlines. Some turned me away right off the bat, saying "no way", and most asked me to call back, send a letter, or leave a message for someone. I didn't get very far with most of them.

Continental Airlines offered me an immediate yes after I talked to their Director of Operations, and they offered me a free flight down to Houston to visit their System Operations Control Center. I made sure I explained what business we were in and that we were not in any way competing with them.

I spent the day at the SOCC and witnessed shift changes occur that were not much different from what we do now. They pass off from one dispatcher to the next with a verbal briefing. They include weather concerns, air traffic concerns, airport concerns with a focus on their hubs, crewing concerns, and the location and status of all flights they are currently responsible for. There is a risk assessment matrix for the flights but not one specifically for the dispatch center.

All in all a great learning experience, and it was very interesting to see such a large-scale operation in practice.
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#13 Gina

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Posted 11 August 2010 - 12:11 PM

Reply: Sure, We have incorporated factors as they apply to 1) Staffing and 2) Fatigue/Human Factors. In the Staffing section,some examples are CS experience in the room, CS in training or recently released from training, first four-week schedule rotation change(day/noc/swing) ,CS called in to cover a shift or on extended hours etc. and in human factors area such criteria as 4th or greater consecutive shift, < 8hrs rest, SX of illness, EAP drill or actual during shift rotation week etc. We have just tried to incorporate factors that may affect the CS function. As I mentioned somewhere along this chain, work-load/flight activity automatically elevates the Risk Score at anytime during the shift.
I don't think I want to throw out the scoring process as we are still experimenting with this entire tool.
I am intrigued by your thought to contact a Part 121 operator to see what they do....please let us know...thanx...Jen


Jem,
I am trying to develop a Risk Matrix for our Comm Center now and I was just wondering how things went for you? Did you get yours implemented and if so how is it working out?
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#14 wellhammered

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Posted 14 December 2010 - 02:20 PM

hey y'all- having flown over 10 years and now in comms due to nursing school and merger; I can tell you that I would evaluate the "risks" involved for comm specs as being those related to making a mistake regarding the aircraft in the air; flight following etc. This job has proven to be far more difficult than back to back pediatric arrests or surgical airways. If you have 8 AC in the air with 12 phone lines, sat phones and 3 radios, overload is unbelieveble. I would relate the risk assessment as well to the areas of do your folks know how to start PAIP, locate a downed AC on map sectional, computer, and then relay that info to ground responders? What about what to do if the power goes out? Can they still get AC to the places needed? Do they respond promptly and appropriately to every alarm or overdue position report? Cultivating good habits means safety is second nature. I agree 100% that we should not make any type decisions regarding AC flights and go vs no go, but we do need to make sure folks are trained to be able to read METARS and weather conditions; should a pilot need that while in air or on multiple back to back flights. Knowing how to use all tools and items available to go the extra mile to ensure the safety of those in the air is not an option. There is so much going on that folks dont think about......................
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#15 Macgyver

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Posted 15 December 2010 - 02:19 AM

Great response - thanks for the insite. I would think that 3-6 active aircraft at once would be appropriate, adjust the number of comspecs on duty to match the average workload. In my experience IFT's and operations under IFR (because they often involve airports thus additional phone traffic to coordinate ambulances etc) tend to take more comspec time than a scene call. Kind of like the difference between fire and ems dispatching - both are pyramids in terms of workload, with the FD being narrow at the start of the response and getting busier and the EMS as lots of traffic initially and less later...

In terms of risk management, one place I worked had 12 dedicated FW and 3 dedicated RW with occasional PRN (rescue) helicopters and specialty teams (FW jets). They ran with a 4 active aircraft per comspec limit and could bring in a supervisor or the relief if things got busy. Staffing was 4 per dayshift plus a supervisor and a manager available for relief, 3 at night with a supervisory relief. Shift start times were adjusted to typical loads and staggered to avoid all being tired at once. All were at least EMT's and many had previous aeromedical experience on the flightline. The other thing they did was use a hightech variation of the old ATC flight slips if they handed off a flight to a second comspec (for example if they were switching regions or transitioning from a scene flight to an IFT on the empty return leg) and at shift change/breaks. Once a flight was launched, that comspec followed it throughout the mission. During peak times for IFT requests one person was assigned purely to the phones to triage/priorise and otherwise deal with incoming IFT requests and to get (extract) the patient info the teams needed from the sending facilities etc.
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Ken BHSc, RN, REMT-P