Testing quality indicators for physician-staffed fixed-wing air medical services in Iceland

Abstract

Objective: Medical evacuation with fixed-wing air ambulances and rescue helicopters plays an important role in Iceland's emergency medical services. The objective of this study was to measure the quality of physician-staffed fixed-wing air ambulance services in Iceland using the 15 response-specific quality indicators (QIs) developed by the EQUIPE consensus group in Scandinavia. Methods: Physicians working in the Icelandic fixed-wing air ambulance service were asked to register response-specific QIs in an online questionnaire after every physician-staffed patient transport undertaken by the service from March 1 to December 31, 2023. Results: The fixed-wing air ambulance service in Iceland did not reach the benchmarks proposed by EQUIPE in 11 of 15 QIs tested. Furthermore, 7 QIs fell in the low performance zone and 4 in the average performance zone. Conclusion: Sparse population density, long transports, and the lack of a single prehospital organizational structure are challenging for Icelandic physician-staffed emergency medical services. This is, to our knowledge, the first time that the quality of the service has been assessed from other perspectives than time and mortality alone. As a result, several areas in need of improvement have been identified in our study.