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Bringing Health and Hope – CareFlite Texas

Careflite Texas

With a recently updated Bell fleet, CareFlite has continued to enhance their medical flight response ability in all weather conditions. With a service area that spans over one hundred counties containing more than 6 million people in the North Texas Area, CareFlite continues to innovate at every opportunity.

By Tim Pruitt

CareFlite in North Texas, operating around the greater Dallas area, was founded as a nonprofit corporation to provide air medical services in 1979. The nonprofit, supported by a board consisting of members from entities within the Texas health care system that strive to keep air medical services in the area “for the people.”

The CareFlite board that runs the organization created intending to represent and provide a voice for each hospital it provided service. Hospitals that include Texas Health Resources, Methodist Health System, Baylor Health Care System, Parkland Health and Hospital System, and the JPS Health Network that all have representation on the CareFlite board.

CareFlite and its member facilities are all nonprofit organizations that aim to provide a higher level of care for every patient, putting the need for quality care above the need to generate profit from their combined helicopter air ambulance service.

The CareFlite board over the years brought in place a management strategy that offered the only fully integrated air medical transport company that gives each hospital network it serves a say in how the company operates.

For eleven years, Jim Swartz has served as the President & CEO of CareFlite and will quickly remind you that the operation exists primarily to “bring help and hope” to all emergency situations to which CareFlite responds.  “My goal is to have all of my people do what is right for all patients, at all times,” Swartz said.

CareFlite operates six helicopter bases around the North Texas area, with helicopters based at Methodist Dallas Medical Center, Harris Methodist Hospital Fort Worth, McKinney Regional Airport, Denton Regional Airport. Careflite also operates from two airport locations, the City of Whitney and Granbury Regional Airports.

HISTORY 

CareFlite was established in 1979, making the company the eighth oldest air medical transport service in the nation and the second oldest in Texas.  The operation began as two hospitals, Methodist Dallas Medical Center and Harris Methodist Hospital in Fort Worth identified the need for an air medical service. The two hospital’s forming a partnership that pooled finances and resources to create what was to become the Careflite organization. The operation commencing operations shortly after the purchase of a Bell 206L Long Ranger fitted with a rudimentary medical interior.

The helicopter was then shared between the two hospitals, rotating every two weeks where the helicopter would be based. In the company’s first year of operations, Careflite averaged transporting and treating twenty patients a month. As the knowledge of CareFlight air medical operations spread over the next year, so too did the calls for service, rapidly increasing in volume to the point that the need began to exceed the capabilities of the current program, ultimately leading to Careflite purchasing a second Bell 206L to cope with the demand.

AIRCRAFT

Careflite has upgraded their fleet over the years from a single Bell206, to a fleet of Bell 429's and 407GX helicopters. Photo by Tim Pruitt
Careflite has upgraded their fleet over the years from a single Bell 206, to a fleet of Bell 429’s and 407GX helicopters. Photo by Tim Pruitt

As CareFlite continued their rapid growth, their strategy evolved to incorporate a larger helicopter to accommodate the needs of patient treatment. The organization then deciding to switch their primary helicopter to the larger Bell 222UT helicopter. The Bell 222 fleet, eventually becoming the backbone of the Careflite operation until 2002 when the company replaced the “Triple Deuce” with a fleet of AgustaWestland made A109 helicopters.

“CareFlite is the only nonprofit service in the area which allows the company to invest its money into equipment and training. We have the latest equipment and newest fleet of state of the art aircraft,” said Swartz.

All options were put on the table when the management team and board of directors began looking to update their fleet. The team started to evaluate the need to add twin-engine redundancy, and evaluate performance and lifting limitations of the current fleet to see which aircraft offered the most “bang for the buck” across all of the needs the organization had. At the forefront of their decision-making process was the priority to maintain current safety margins, with the hope to increase margins with newer equipment that featured the most practical and functional technology that would hopefully add to the company’s value proposition for those they served.

The A109s served the organization until late 2015, as CareFlite then began taking delivery of the first of the next aircraft the company had decided would become part of the ongoing efforts to increase the company’s safety and service levels, choosing the Bell 407GX.  The replacement process, including procurement of the new helicopters, including switching back to the American-made Bell, manufactured right in Careflite’s backyard at the Bell facility in Fort Worth, a complex one from a maintenance standpoint when transitioning from the Italian made A109s.

MODERNIZING THE FLEET

The Bell 407GX selected by CareFlite for its power, speed and quiet ride in air ambulance configuration. The 407GX’s selected by CareFlite are configured to carry two critical care medical personnel that provide care for one patient onboard the helicopter.

CareFlite chose the 407 based not only on the speed and agility of the airframe but the ease of use for their critical care staff in treating patients in the large 85 ft³ cabin. The 407GX features the Garmin G1000H™ flight deck, providing critical flight information at a glance for greater situational awareness and increased safety, including Helicopter Terrain Avoidance Warning System, Helicopter Synthetic Vision Technology™, Traffic Information Systems and more.

The 407GX also features a tail rotor camera, allowing the pilot a clear view of the tail during take-offs. In December of 2016, they will take delivery of a fifth 407GX, and this will be used as a spare or for training, so they do not have to take a base out of service during training operations.

Careflite took delivery of the larger Bell 429 to increase their abilities in patient treatment in flight. Photo by Tim Pruitt
Careflite took delivery of the larger Bell 429 to increase their abilities in patient treatment in flight. Photo by Tim Pruitt

In early 2016 CareFlite took delivery of two Bell 429s, one of the most advanced light twin helicopters now on the market. The CareFlite 429s delivered were IFR capable aircraft fitted with a fully integrated glass cockpit and WAAS weather system. The Bell twin offering more main and aft cabin space for the organization’s crews.  It’s the only light twin-engine helicopter on the market that offers two-litter capability with enough room for two medical crew members plus pilots or, three medical crew and a pilot.

One of the factors in the selection of the 429 by CareFlite was Bell’s effort in certifying the 429 in the MSG-3 process, which resulted in reduced maintenance costs for operators.  The 429s operated by CareFlite are now able to use any of the seventeen area hospitals featuring FAA-approved instrument approach equipped helipads.  This increasing CareFlite’s ability to transport critical patients to area trauma centers and other hospitals that offer specialized care during poor weather conditions that may limit response from VFR only operations.  CareFlite is the first non-governmental entity able to provide that ability in Texas.

CareFlite also operates a King Air fixed wing aircraft for long haul patient transfer throughout the United States for emergent and non-emergent transport.  The fixed wing platform is ideal for organ transplant teams to facilitate rapid organ delivery, time often a crucial factor in the success of transplant cases.  CareFlite’s King Air also features a pressurized cabin, allowing the aircraft the ability to fly at higher altitudes and faster speeds while also being IFR capable for all weather response.

QUALITY OF CARE

Quality of care is paramount among all Careflite medical staff, who are selected from the best of the best in medical professionals. Photo by Tim Pruitt
Quality of care is paramount among all Careflite medical staff, who are selected from the best of the best in medical professionals. Photo by Tim Pruitt

CareFlite responds to calls for service from hospitals, fire departments, EMS and law enforcement agencies within a 150-mile radius of the greater Dallas/Fort Worth area that includes more than 100 counties serving more than 6 million people.

CareFlite can also provide specialist in-flight services for medical cases like neonatal emergency care.  Specialty care given during these types of missions, turning the back of a Careflite helicopter into an airborne NICU unit if needed.  CareFlite helicopters are also equipped with other state-of-the-art equipment for in-flight trauma care such as an Extracorporeal Membrane Oxygenation (ECMO) machine that can take over the function of the lungs or heart of a patient in flight if required. Careflite aircraft are also fitted with an Intra-Aortic Balloon Pump and Impeller that can be used in the treatment of patients with life-threatening heart conditions.

“We are blessed to be able to help so many people and enjoy the challenge that comes with a job like this. It is a very rewarding line of work helping others and making a difference in someone’s life.  Being a  multi-mode operation means that we have different experiences each and every day.  You may start your shift on the helicopter, but if weather falls below IFR minimums, we may finish out a shift in a ground ambulance.” Said Teresa Campbell, a Senior Flight Nurse that has been with CareFlite for over twenty years.

“Retrieving stroke patients from outlying areas and being able to transport them to comprehensive stroke centers are time sensitive missions, getting the patient to specialized care is a life saver.  The helicopter is the most efficient method of getting patients to the right facility, and doing it quickly” she added.

MAINTENANCE

James Lindsley, one of CareFlite’s in-house mechanics, has a daily routine that focuses entirely on the single task of keeping CareFlight aircraft flight ready and safe. Each CareFlight base is assigned a mechanic that handles day to day issues, in addition to the company’s maintenance facility located at the CareFlite Grand Prairie base where more complex scheduled maintenance tasks are carried out as needed.  CareFlight can perform all levels of maintenance in-house, with the exception of avionics and engine overhauls. The facility even features its in-house paint and sheet metal shop.

“We are fortunate at CareFlite to have full support from the board.  That allows us all to provide a safe program that delivers the highest quality care available as well as exceeding all of the national standards for safety.”

Careflite maintains all of its own aircraft, supplying a mechanic for each base, only requiring to move aircraft to the main base for large scale maintenance tasks. Photo by Tim Pruitt
Careflite maintains all of its own aircraft, supplying a mechanic for each base, only requiring to move aircraft to the main base for large scale maintenance tasks. Photo by Tim Pruitt

TRAINING

Each pilot is required to have an Airline Transport Pilot (ATP) rating and several thousand flight hours before being considered for a pilot position at Careflite, and the training and certification requirements are equally as stringent for medical teams that also undergo rigorous training to obtain their initial certification and maintain their flight status annually. Each flight nurse is required to be a Certified Flight Registered Nurse (CFRN) and have a minimum of five years critical care or emergency nursing experience before being considered for a flying role.  Additionally, flight paramedics must be a Flight Paramedic-Certified (FP-C) with at least four years of progressive experience.

All medical crewmembers also hold advanced certifications in trauma, cardiac, neonatal, obstetrics, pediatrics, and burn care.

CareFlite also operates a Clinical Quality and Education Department within their organization that provides high-quality educational opportunities for its employees, first responders, and other healthcare professionals.  Their Education Outreach program offers monthly courses to meet continuing education requirements that are also certified by the Texas Department of Health and Commission on the Accreditation of Medical Transport Systems (CAMTS).

Careflite serves not only as a medical operator, but as a primary dispatch center in the Dallas area for two counties. Photo by Tim Pruitt
Careflite serves not only as a medical operator but also as a primary dispatch center in the Dallas area for two counties. Photo by Tim Pruitt

THINKING OUTSIDE THE BOX

While most critical care providers in the air medical business often have their own control rooms that dispatch and track their aircraft, such is CareFlite’s commitment to the communities that they serve; the organization went a step further in providing a service that provides more than just a standard helicopter dispatch center. CareFlite decided to offer full 911 call center capability, which has since grown to include being the primary 911 dispatch center that provides service for Johnson, Hill, and Kauffman counties that provide service for almost three hundred thousand residents in the southern and eastern outskirts of the greater Dallas area.

CONCLUSION

It is evident that Careflite places its reputation squarely behind the belief that the organization’s people are its greatest asset, and the goal is to provide a safe, rapid transport with the highest quality of care delivered to each patient. CareFlite has proven over their years of safe operation, that they possess a continued desire to drive their positive safety culture. Careflite’s purchase of their all new fleet will ensure the organization will continue to bring “help and hope” to the citizens of North Texas for years to come.

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