Analysis of Decision-Making Process in Helicopter Emergency Medical Service

Introduction

In the ambulance service, the helicopter emergency medical service (HEMS) (see Figure 1) of the rapidity and the usefulness has been highly regarded, and it is also effective in reducing regional medical service differences which have occurred in recent years (Kohama, 2003; Sakata, 2006; JSAS, 2007; Masuko, 2007; Akiya, 2009; Nishikawa, 2009; Wisha, 2009). The captain, maintenance men, doctors and nurses plane together and leave for the site. The communication specialist (CS) is stationed in the base hospital and adjusts the information about the navigation management of flight safety and the facilities involved. The navigation of the HEMS is likely to be affected by the weather and land forms because it is conducted by visual flight. The captain flies without using visual assistance to keep some distance between the helicopter and clouds or obstacles. Under the present conditions, the CS and the captain of HEMS contact each other and select the safest flight path. With the increase in future requests, conducting safe and effective navigation is a challenge of the CS. However, the CS is sent from an airline in rotation so it is difficult to say that all CSs conduct their duties with profound knowledge and experience about the detailed weather and land forms in the navigation area. In addition, a reasonable amount of time is needed to standardize their knowledge and experience (Nonaka and Takeuchi, 1995; Suchman, 1987; Nonaka, 1990). Consequently in our research, we focused on the understanding and assessment of the situation and the process of the decision-making and then analyzed them. We also interviewed the CS directly, and proposed to develop a system which can make up for the differences in the knowledge and experience of individual CSs (Maededa, 2010).

Figure 1.

HEMS

The Outline Of Cs Service

The CS is assigned to each HEMS base hospital by the navigation company and conducts the job in rotation. The CS service receives a telegram of the requested dispatch by a hot line, makes adjustments with the facilities involved, watches and supports the navigation, manages the information for the activity, and makes confirmations of the weather (Figure 2). In receiving the request of the dispatch by the hot line, they follow the information about the emergency information from the fire service. The information is regarding the condition of the patient and the place where the helicopter can land, and the current status of the fire service. After following the dispatch request, the CS judges whether the dispatch is possible or not based on the information about the weather, even though it was previously confirmed, and promptly conducts the HEMS dispatch. After the HEMS lands, the CS adjusts the information which is changing every moment using a radio or a phone, and continues to support and keep watch on the navigation. When the patient is carried to the appropriate hospital and the HEMS returns to the base hospital, CS support is finished and the CS continues to wait for the next request.

Figure 2.

The CS working in the communications center

Method Of Analysis

In this research, we analyzed duties of the CS using ethno-methodology.