Estimated reading time 6 minutes, 42 seconds.
Interim Ornge president and CEO Ron McKerlie told attendees at an Economic Club of Canada meeting in Toronto yesterday that he was “more than a little taken aback” when he assumed command of Ornge in January 2012, and realized the extent of the problems on his plate.
He had his work cut out for him, to be sure. The misuse of public funds scandal that erupted last December had destroyed employee morale and shattered public trust in Ornge. There was nothing for McKerlie and his team to do but roll up their sleeves and begin the process of rebuilding a second-to-none transport medicine service – one that was not only transparent, but also fully accountable to the taxpayers that fund it.
A significant milestone on the road to recovery was the signing of a new performance agreement with the Ministry of Health and Long-Term Care (MOHLTC) earlier this year, which spells out how Ornge will be held fully accountable for its use of public funds. McKerlie said the agreement is the foundation of a new, more transparent Ornge, an operation that is committed to serving as many patients as possible using precious finite resources.
Once that agreement was successfully concluded, McKerlie said he focused on dealing with “some of the more fundamental challenges and issues of running an air ambulance service.”
One of those fundamental challenges was addressing the problems paramedics encountered with the interior medical configuration on Ornge’s fleet of AgustaWestland AW139 helicopters. Simply put, it was impossible to perform CPR effectively during the taxi, takeoff and landing phases of flight. At those times, paramedics had to be belted in, and the stretchers raised patients too high, where chest compressions could not be performed.
Transport Canada (TC) granted Ornge a temporary exemption to keep the stretcher in a transverse position during taxi, takeoff and landing, which meant patients were in a position to receive CPR. However, that exemption expires on Feb. 2, 2013, and Ornge has been working toward two goals in the meantime: equipping the helicopters with a workable interim interior that is closer to the standard EMS configuration for the AW139; and, moving to come up with a permanent plan that will see the AW139 interiors redesigned yet again to fully meet operational needs.
“What we’re creating right now is a different interim interior where the patient will actually fly closer to the floor,” McKerlie told Canadian Skies after his speech. “We’ll be able to do chest compressions for CPR. That has to be certified by Transport Canada and we’re going through that certification process.”
The interim configuration is undergoing testing now, and employee feedback is being sought in advance of the Feb. 2 certification deadline. Once TC approval is obtained, Ornge will have time to come up with its new and permanent helicopter interior configuration. An RFP for the newly redesigned interior is expected to go out in 2013; in the meantime, Ornge is collecting employee feedback on how the new interiors should be designed.
Examining Efficiencies
In August, Ornge launched a pilot project with Air Bravo, a long-time private sector partner, which sees them providing a dedicated patient flight service in the busy Sault Ste. Marie – Sudbury corridor. Air Bravo aircraft and crews transport patients who are seriously ill or who have scheduled appointments between the two cities. Two patients can be transported at once and the service operates five days per week.
“The advantage to us is that it frees up our helicopter in Sudbury and our fixed wing aircraft in Timmins and Thunder Bay,” explained McKerlie. “It leaves our aircraft available to do the critical care and scene responses in the area.” He added that Ornge is evaluating its mission profiles and routes travelled to ensure the right assets are being used on the right routes.
Another example of these efforts comes from Eastern Ontario, where land transport is being better utilized in the Ottawa area. “Under the new trial,” McKerlie told meeting attendees, “we will dispatch our critical care land ambulances rather than helicopters to perform inter-facility transports at several community hospitals in close proximity to the city.”
He added that there will be more initiatives like these in future, designed to maximize taxpayer dollars and to best utilize resources.
Lessons Learned
McKerlie offered up five lessons he said he’s learned from his time at Ornge:
1. You can’t emerge from a crisis by hiding in a bunker – that won’t restore anyone’s pride in what they do for a living.
2. Never lose focus on your core business – in this case, it’s providing high-quality medical transport.
3. Put your clients first – patients are not just numbers in a database.
4. Listen to your employees – open up new lines of communication with your staff.
5. Engage or re-engage your partners – reach out to experts for guidance and advice.
McKerlie said Ornge is a vastly different organization from what it was as little as nine months ago. “In the end, there is only one way we can earn back the respect of the people of Ontario. That is by providing them with an air ambulance service that is second to none in terms of quality, openness and patient-centred care,” he concluded.
