Table 4 Potential quality improvement areas, goals, and interventions in avalanche rescue
Area | Goals | Interventions | Target |
|---|---|---|---|
HEMS operations, search & technical rescue | Optimize avalanche rescue readiness to improve time efficiency (reduce time to extrication) while maintaining or increasing safety | Checklist for daily control of the personal safety equipment (clothes, avalanche beacon, AvaLung) | Providers |
Checklist for daily control of the avalanche rescue material (Helicopter external avalanche beacon, RECCO® device, probes, shovels) | Providers | ||
Use of a standard operating procedure for avalanche rescue missions | Providers | ||
The HEMS physician systematically wears a harness for avalanche rescue missions | HEMS physician | ||
Regular training of winch procedures | Providers | ||
Achieve a high level of performance in locating and digging out avalanche victims to reduce time to extrication | Regular specific field training including single and multiple burial scenarios | Providers | |
Medical management | Improve quality level of avalanche victim management | Dissemination of guidelines, up-to-date algorithm and clinical practice recommendations at the beginning of the winter season | Providers |
Continuous audit of avalanche rescue missions and feedback to HEMS providers | Topic expert, project leader | ||
Standard operating procedure for the management of avalanche victims in cardiac arrest | Providers | ||
Targeted training delivered via workshops and field training at the beginning of the winter season | Providers | ||
Indoor medical management simulation | Providers | ||
Improve adequacy to the algorithm | Use of the Avalanche Victim Resuscitation Checklist | Providers | |
Improve quality of information transmission on site and to the hospital teams | Use of the Avalanche Victim Resuscitation Checklist | Providers | |
Data collection | Improve quality & completeness of data in our database for avalanche rescue missions | Development of a template for uniform data documentation and reporting for avalanche rescue missions through a consensus process (minimal data set) | Expert panel |
Continuous quality improvement | Measure and improve quality | Development of quality indicators for avalanche rescue missions and management of avalanche victims through a consensus process | Topic experts, providers, relevant stakeholders |
Monitoring of quality indicators & reporting to the crews | Quality manager |