“Change is the only constant in life” was famously declared by Benjamin Franklin. In medical transport, change is even more constant than in most stationary businesses. The health care profession overall has been especially challenged by 3 years of a pandemic while trying to maintain the same level of quality and safety. Accredited programs are expected to maintain substantial compliance with the accreditation standards throughout the tenure of accreditation and are expected to report changes within 30 days. These changes can be as minor as a change of address or as major as a change in ownership, operator, or acquisition of another program. The Commission on Accreditation of Medical Transport Systems (CAMTS) has a policy that addresses “reporting changes” with the possible actions that may result from those changes. For example, if a new base is opened or changed, there is a specific report, including pictures, required. A new base or acquisition (acquiring another program) may require a supplemental visit. Recently, opening bases or acquiring other programs has led to a change in CAMTS policies. Organizing a large site visit to a service with many bases often takes several weeks of planning by the CAMTS office and site survey team. Recently, new bases have been reported during the process of planning a site visit, making it difficult to change the touring and interviews already scheduled. When the board met in October, the policy was changed to require a deadline for this type of change. Once the program information folder (PIF) is submitted and the online file is locked, usually 4 weeks or more before a site visit, no further changes will be accepted. If a base is opened or another program is acquired within that time frame, a report of change is still required, but it will not be considered part of the accreditation and cannot be advertised as accredited until a supplemental site visit is performed at the new base. The goal is to conduct a supplemental site visit within 6 months. This also allows the service to get the base fully operating in a reasonable time frame without rushing to include it in an accreditation site visit. Opening or moving bases may be a disruptive change to management and staff, but there are other changes that impact the stability of medical transport services. For example, management changes, operator changes, or an incident or accident also challenge the program's ability to maintain a consistent level of quality and safety. We have been shocked by several programs that were fully accredited in the past but did not achieve full accreditation in the current reapplication. Management changes, especially middle managers (eg, the program director, lead pilot, clinical director, or communications manager) who are part of the day-to day operations, may impact the crews’ ability to adjust and maintain a consistent direction. The board has approved delays in submitting PIFs if requested by programs that are at the end of their tenure of accreditation and experience major changes such as a new operator or staffing issues, which many services experienced because of the pandemic. If major changes occur with 1 year or more remaining in the current tenure, the board may require a supplemental visit. New applicants have up to 1 year to submit a PIF, but the board has also approved extending that deadline for very similar reasons. The tenure of accreditation is 3 years. This follows the findings of many accreditation agencies that use 3 years as the benchmark because of changes that occur in every form of health care and because standards are revised every 3 to 4 years to keep current with new practices and procedures. Please view policy changes that are highlighted after every board meeting and found on the website under “Resources” at www.camts.org or www.camtsglobal.org. Eileen Frazer, RN, CMTE, is the CAMTS executive director. She can be reached at [email protected] and (864) 287-4177.
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Jul 27, 2023
Douglas Clem 
Open Access
