Thesis: Patient Safety in Helicopter Emergency Services - Time to lift off? A mixed methods study
In recent decades, the increased focus on patient safety within healthcare has not received the same level of attention in helicopter emergency medicine services (HEMS). This thesis is based on quantitative and qualitative studies using a mixed-methods approach to explore how the conditions of HEMS operations might impact patient safety, particularly focusing on organisational factors, non-technical skills training, and the culture of incident reporting.
In the first of the three studies, we surveyed medical directors of international HEMS regarding their perceptions of patient and flight safety across various medical staffing models. This study also gathered information on the differences in education, competencies, and combinations employed in HEMS worldwide. The second survey evaluated the frequency of training and assessment of non-technical skills in Norwegian HEMS. Lastly, in-depth interviews with Norwegian HEMS physicians on the culture of incident reporting and risk areas provided further valuable insights into the research theme. We performed a deductive and semantic thematic analysis, utilising predefined themes derived from previous research and patient safety literature, as well as our individual papers. The themes were categorised according to efficiency, following established root-cause analysis frameworks.
An essential premise for improving patient safety in HEMS is establishing a national system for reporting medical incidents and near misses. This system should facilitate learning across different bases while ensuring anonymity. Furthermore, additional system-based actions must be prioritised to enhance patient safety in HEMS. Such actions include making helicopter and staffing decisions based on mission profiles, standardising medical equipment, medication protocols, and the handover process with local hospitals, as well as mandatory training in and assessment of non-technical skills using behavioural marker tools.
Kristen Rasmussen was born in Mandal. He studied medicine at Johannes Gutenberg University in Mainz, Germany, and the University of Oslo. He has been practising as an anaesthesiologist and air ambulance physician in Ålesund for 30 years. He was a PhD student at the Faculty of Health Sciences and Norwegian Air Ambulance Foundation and defended his thesis on August 20th 2024.
Supervisors
Main supervisor:
Professor Karina Professor Stephen J. M. Sollid, University of Stavanger
Co-supervisor:
Prof. Marit Kvangarsnes, Norwegian University of Science and Technology - Ålesund
Ass. Prof. Håkon B Abrahamsen, University of Stavanger
