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Every industry has its own Bermuda Triangle when it comes to project management. We all want our projects completed on target exactly as we specified, delivered on time, and at or under budget. We’ve heard the old adage, you can achieve one—maybe two—of the three goals, but never all three. We challenged that theory and will show you how you can achieve the trifecta on your next emergency medical service (EMS) aircraft customization.

A SMOOTH TAKE OFF We’ve all been there … after months of scrutinizing budgets, tracking industry trends and poring over projections, the decision to purchase a new EMS aircraft is finally set in stone. Whew! The hard part is over right? Those of us who’ve been there, done that, know it’s just the beginning.

VEERING OFF COURSE Aircraft selection involves comparing performance data, load factors, mission availabilities and the initial cost of purchase, as well as the ongoing cost of operation and maintenance. This step alone can take months and before you know it, there’s only a small window between the tedious final aircraft approval process and the required launch date to configure and install the medical interior. Already we’re at the point of eliminating one of our goals and for many operations, it’s the target that takes a direct hit.

Case Study: Saudi Arabia Search and Rescue Fleet

This SAR fleet of Sikorsky S92 helicopters needed to be integrated and outfitted within a 90-day delivery window.

The EMS manufacturer outfitted the utility-style interiors with advanced life support systems, stretcher bridges and 3-drawer cabinets with provisions for defibrillator equipment. The project was completed ahead of time and included equipment integration and on-site training.

Too often a time crunch forces companies to sacrifice their plans of the ideal medical interior for their mission profile. Instead, they settle for standardized equipment that has already been developed for someone else and adapt their configuration to utilize existing equipment so they can meet deadline goals. Certainly, the end result will be an aircraft with a functional medical interior, but somewhere along the line, the original wants and needs of the medical crew were compromised and the ergonomic specs of the tailor-made configuration became obsolete, thereby shaving valuable operational efficiencies from the mission profile. Tragically, for search and rescue (SAR) and EMS aircraft missions, time is precious and minutes can mean the difference between life or death. In a majority of cases where compromises are imposed, customers return for modifications after the project is complete. At this point, even small changes are much more costly and difficult to administer resulting in additional budget allocation and operational downtime for the aircraft.

In the case of private individuals, charter companies or organizations that already have an operating fleet of aircraft, the desire for customized equipment can often take precedence, and the delivery date takes a backseat so equipment manufacturers, certification authorities and completion centers can finish their part in the customization process. Because customization by definition is created according to unique specifications, the process requires absolute precision for a successful outcome. When any one of the three goals fails to hit the mark, the source of the problem is nearly always traced back to a break in the communication stream. With so many entities—owners, operators, flight staff, medical teams and maintenance crews, aircraft manufacturers, equipment designers and manufacturers, mechanical teams, regulatory boards, certification authorities and completion centers – involved in the customization process, it’s little wonder projects veer off course due to misunderstandings and sheer confusion.

RIGHT ON TRACK Customization projects completed on target, on budget and on time all share one critical component – communication. It sounds simple, but it’s easier said than done. The cornerstone of a successful project management process is to maintain comprehensive and transparent communications at all times. When everyone knows what’s happening and how projects are progressing, there are no surprises, no frustrations and no disappointments when the project is complete.

Let’s take a closer look at the project management process and some tools that can help expedite a victorious result. These insights and recommendations are intended to benefit both customers and vendors. Customers will be empowered with higher levels of communication allowing them to remain engaged, while vendors may discover some new tools and work flow strategies to help meet customer expectations.

Communication Tools As soon as a project has been awarded, a project summary outlining the details of the signed purchase order should be prepared. Barring any changes to that summary, collaborative work begins with the owners, operators, aircraft manufacturer, medical crew, maintenance crew and anyone else involved in the project, to establish a fine-tuned scope of work. From this, the engineering and design teams begin the equipment design based on the customer’s specs. Upon design completion and client approval, a design freeze should be issued from the engineering team. The project cannot continue without the critical design review (CDR) being completed and agreed upon by both parties. This review ensures both large and small details are addressed before the drawings are put into production and it keeps everyone engaged and informed throughout the design stage.

Internally, manufacturers should be meeting at least weekly to review projects and monitor progress according to the production timelines. A Gantt calendar may be useful for tracking multiple projects, as well as specific tasks for equipment and people. It’s the best way to minimize the over-tasking of time and resources. And, helpful for teams to have a visual indicator of project tasks, milestones and progress status.

Clients should demand weekly project summary updates with full timeline details and current status reports provided by the project management team. Change order authorizations (COA) are recommended to track any and all changes to the original scope of work. The details of the change are documented and sent to the customer for review and approval. Before beginning any of the changes, the COA must be signed by both parties to avoid misunderstandings and costly mistakes. The COA clearly describes the changes being requested along with any resulting costs or revisions to the production timeline.

There are scads of project management software programs, documents, spreadsheets and high-tech gadgets on the market, all promising increased productivity and profitability. Whether you choose to use a ready-made solution or create your own, satisfaction hinges on weaving your external and internal communication tools together to form an easy flow of information throughout the life of the project. The purpose of this integration is to keep everyone’s finger on the pulse of the project at every stage of development to enable each team to concentrate attention on their respective responsibilities while remaining cognizant of the global project. Additionally, when small issues do arise, they are resolved immediately preventing the landslides that often have the potential to derail delivery dates and overload budgets.

OVERCOMING COMMON STUMBLING BLOCKS One of the most common hurdles in a customization project is lack of detailed information on the aircraft. Spacial and mechanical specs are critical prior to the design team beginning their development efforts. CAD drawings and on-site aircraft evaluations greatly reduce the risk of potential project hazards that might not otherwise be discovered until the interior conformity inspections. When something as simple as identifying electrical power capacity is overlooked or forgotten, it can mean going back to the drawing board to adapt monitors for battery operation. By incorporating these considerations into the early stages of the project scope, the customization process continues to progress unencumbered.

Case Study: Jet Budget Caribbean Charter Company

Cessna designed the Mustang as a multi-mission aircraft, ideal for air medical transport operators. The first completed aircraft was already presold to a charter company planning to add medical transport services to its mission profile.

In this case, the medical equipment manufacturer collaborated directly with the aircraft manufacturer to pre-fit the Mustang. The aircraft was prewired for the medical equipment provider‘s advanced life support system with storage provisions customized to the Mustang.

“The versatility of the Mustang and the quality air medical equipment our air medical vendor produces make this an ideal multi-mission aircraft. Operators will save a substantial amount of time when compared to retro-fitting an aircraft so it’s a great opportunity for everyone.“ ~ Scott Sarver, manager of special mission sales for Cessna

Certification is another area riddled with potential pitfalls, the first of which is uncertainty about what level of certification is necessary. While some modifications can be approved with a field approval process for that particular aircraft serial number, others require a Supplemental Type Certificate (STC) that applies to your entire fleet. Your flight standards district office can help you determine which is the right course of action for your customization project.

If an STC is required, an arduous and time-intensive process ensues to produce equipment modifications that must pass airworthiness and conformity inspections at each stage of development. Results of these successful inspections are sent to the FAA and upon their review, the STC is granted. Depending on the complexity of the design and installation, the STC approval process can last between three to six months. In cases like this, consistent and regular communication is invaluable to customers who don’t have time to track the certification process on their own.

Case in Point: Los Angeles Fire Department – Special Missions

The air operations section of LAFD wanted a custom medical module to safely hold specific medical equipment for emergency medical transport missions.

LAFD‘s preferred air medical equipment manufacturer worked with the special missions staff at their facility to get a better understanding of how this proposed unit was expected to function. As a result, they designed, engineered and installed a one-of-a-kind medical stand to fit the exact space dimensions of the aircraft. The unit is floor-and ceiling-mounted for stability and a quick-release capability to remove medical equipment for patient transfer.

“We expect our multi-mission aircraft to perform in any situation and any environment. This means our advanced medical equipment needs to be versatile, meet the aircraft mission requirements and be functional for the pilots and aeromedical crew. This company communicated with us step-by-step through the design concept, purchase order, prototype development, critical design review, project updates, certification and final delivery. We needed a custom product to fit our needs, and now we have it.” ~ Chief Joseph Foley, LAFD

One other major concern of customers comes at the end of a project. Customer service and support after a project is complete can too easily slide into the out-of-sight, out-of-mind category. Customers want to know they can reach a technician to troubleshoot any problems. They need to know how to acquire new, warranty or replacement parts. Customer-focused vendors will implement a follow-up communication strategy to address these issues and solicit feedback from customers a few weeks after their project is complete so that all aspects of the project are still fresh in everyone‘s minds.

APPLAUD A COLLABORATIVE SPIRIT More often than not, a single manufacturer cannot independently handle every aspect and detail of a project internally, especially when timelines are unusually constrictive. As a customer, avoid being swayed into thinking a manufacturer who partners with outside engineering firms, completion centers and other resources is lacking in expertise or commitment to your project. The opposite in fact may be true; you very likely are receiving extraordinary expertise because of the specialization that is being outsourced on your behalf.

Case in Point: Life Flight Intermountain Healthcare (IHC)

IHC added three AgustaWestland Grand New helicopters to their Life Flight program, which already included Bell 407s, AgustaWestland K2s and King Air 200s. The existing fleet featured a custom interfacing solution allowing an infant transport deck to be interchanged among all the aircraft. The customization project also included interfacing medical monitoring devices and other neonatal care components. The addition of the AW Grand News required another custom configuration to maintain the interchangeability.

The air medical equipment manufacturer partnered with an engineering design firm to develop the first US-certified air medical interiors for the AW Grand New helicopter. Customized configurations included single-patient stretcher platform, secondary foldable and stowable patient stretcher, and a comprehensive advanced life support package including medical oxygen, suction, compressed air and electric inverters.

“Our situation was complex, we needed someone to work side by side with us so our result was flawless. The EMS equipment partner we chose for our first project made our customization a success. Now, we find ourselves in the same situation as we move into new AgustaWestland Grand New aircraft requiring the same compatibility. We have confidence knowing that we can rely on them again to take the time to understand our needs and get the project right the first time.“ ~ Tammy Bleak, Manager Children’s Services, Intermountain Life Flight

A CONSISTENT WINNER For those of you thinking the process wouldn’t work for your situation, think again. Whether a customization project originates with an aircraft manufacturer, a multi-mission operator or a company expanding their fleet, manufacturers who adhere to this winning approach are sought-after partners in today’s competitive marketplace.

The four case studies scattered throughout this article feature unrelated clients, located in different parts of the world, all needing custom solutions to unique problems. As random as these examples may seem, they do in fact share a common denominator. They were all completed by the same manufacturer – a manufacturer who has its project management system down to a science.

Spectrum Aeromed, a relatively small company headquartered in Fargo, ND, is a text-book example of how a solid project management system can produce profound results. Spectrum Aeromed manufactures air medical equipment with unprecedented speed and accuracy. Check out their stats: • standard equipment is turned around in 45 days or less • 90-95% on-time delivery record for the past 12 months • projects outside delivery dates were delivered within a 10-day window of the original date When asked to reveal what makes Spectrum Aeromed different from the other air medical equipment manufacturers, Bruce Gullingsrud, vice president of business development for Spectrum Aeromed (former employee of one of its major competitors), nonchalantly shrugs and says, “There’s no big secret. The industry pain points have been the same for decades. We just avoid the common pitfalls by remembering that great communication involves three components – two ears and one mouth. We respect the inherent wisdom of that ratio and listen first, respond second.“