Recommended Practice (Final) RP5 - To Discourage Helicopter/Fixed Wing Shopping by EMS or Medical Providers and provide a Method of Information Sharing   A hazardous practice that we have observed far too many times over the years that this council considers a high risk to EMS transport operations is what has become known as “helicopter/fixed wing shopping”. The basic scenario is similar this one below:   A hospital or an EMS field provider has a patient whom they assess as requiring medical transportation to a specialty facility or trauma center and they initiate a call to their closest or most frequently utilized EMS communications center for a helicopter or fixed wing service. After that call is received by the aviation provider, it is determined by the PIC that the current or forecast weather will prevent them from safely complying with the request for air medical transport. That information is relayed back to the requesting agency or hospital. At this time, the requestor still has a need to move this patient expeditiously and begins to “shop” for another aviation provider. Often, the fact that another provider had been requested and turned down the flight is not included in their requesting process so the current aviation provider (and especially the PIC) who needs to make the “go, no-go” decision is unaware that weather or other safety considerations caused this flight request to be turned down by a previous PIC. The information that the flight was turned down by a previous service and PIC may be a valuable clue to another pilot’s awareness of deteriorating or local weather conditions only known of by the first requested pilot. Often, the requesting agency does not relay “turn-down” information that would be invaluable in a PIC’s decision making process or, on occasion, it is consciously omitted from their request with the hope that another aircraft might try nonetheless. We also have a situation wherein a PIC has ignored this invaluable information and taken a flight that should have been turned-down.   We believe that open and accurate sharing of weather and/or hazard information is critical to EMS aviation safety and the failure to pass on or utilize such information can result in higher risk to EMS flight teams or contribute to weather related accidents. We recommend the following as risk mitigation techniques:   1. Programs and, in particular Aviation Managers, periodically meet with regional EMS aviation operators and establish a letter of agreement that defines how information sharing about flights refused due to weather or other hazards will be handled. This should include an automatic method of telephonic and/or email notification of regional flight programs or dispatch centers that may potentially be called by an EMS provider or hospital.   2. Communications Centers have policies and procedures that align with regional safety council agreements to inform flight programs and their pilots of flights that have been turned down due to weather or other potentially common hazards. These policies should clearly define the radius around a program or base requiring notification of other programs/bases. The communications methodology should be clearly defined and periodically tested.   3. It is recommended that communications centers have a protocol, when appropriate, to determine whether the requesting agency has previously requested any other transport service and has been refused due to weather or other hazard.   4. It is recommended that such shopping policies include the ability to contact the other PIC directly so that a pilot-to-pilot discussion of relevant weather issues can take place.   5. Flight programs continually educate their supported EMS agencies, dispatch centers, and hospitals about the inherent risks of helicopter/fixed wing shopping and support the value that any flight programs contacted after a turned-down flight be informed of the reason why a program turned a flight down, e.g., weather at destination hospital, VFR vs. IFR programs, etc.   6. Regional Programs should have a timely local NOTAM system to share other safety information or hazard/weather information with their competition or partners.   We recognize that there may be variables such as location, terrain, localized weather conditions, pilot experience, duty time, fatigue, program culture, AMRM, different weather minimums, and comfort levels that will affect whether or not an individual pilot will accept or refuse a flight. This RP is not intended to change how a pilot and crew make a go or no-go decision. We simply want to insure that a pilot has all relevant information to make an informed decision. Because another program has turned down a flight does not mean that another could not complete a flight safely. Knowing that another program has turned down a flight may be just another indicator to a pilot that further investigation and planning may be necessary. It may also be an important and timely warning that the proposed flight has a higher risk than he or she may have originally noted.     Recommended Practices are published under the direction of the Air Medical Safety Advisory Council (AMSAC). RPs are a medium for discussion of aviation and medical operational safety pertinent to the Air Medical Community. RPs are not intended to replace corporate judgment, Federal Aviation Regulations, Company Operations Manuals, or Organizational SOPs. Suggestions for subject matter are cordially invited. back