06. D-Flight Operations.pdf

Attachment D

PIMC Flight Operations And

New Employee Orientation (Revision April 2021)

I. Introduction

Our mission calls us to serve Native Americans throughout Arizona, Nevada, Utah, and California. This wide geographic distribution presents a significant logistic burden involving frequent travel by many of our providers. The volume, complexity, and high cost of this travel necessitate a structured process for its effective and efficient operation. This document defines the operational procedures, duties, and responsibilities of the PIMC staff serving PIMC flight operations as well as the traveling staff. This document is also provided:

• As orientation of the new traveler to this system, and

• To describe internal policies and procedures that governs aviation, and the roles and responsibilities of the Field Operations staff and the PIMC/PSU traveler.

II. Organization

1. Chief, Support Services: Anne Silversmith Anne.Silversmith@ihs.gov

(602) 263-1500

2. Field Operations Coordinator: CDR Randy Saria Randy.Saria@ihs.gov

(602) 263-1677

3. Transportation Office: Kelly Tadytin Kelly.tadytin@ihs.gov 602 263-1503

PIMC flight operations are established by policy and procedures, and meet or exceed IHS/HHS rules and regulations (Chapter 36 - Aviation Management and Safety, Part 5 - Management Services, https://www.ihs.gov/ihm/pc/part-5/p5c36/). This program is managed centrally through the Office of Support Services. The Field Operations Coordinator is responsible for the dispatch of all charter flights with departmental coordination by the department Flight Coordinator as assigned by the Department Chief. The Field Operations Coordinator is the primary contact for all charter flight issues and gives advice to Administration and direction to the Transportation Office staff in matters relating to the flights. The purpose of this team is to provide safe, timely, comfortable, and cost effective transportation to the field. Successful completion of this goal depends upon timely and effective interaction of the Field Operations Coordinator with the Department Flight Coordinator, traveler, Field Service Units (SU), and contract air charter vendors.

mailto:Anne.Silversmith@ihs.gov mailto:Randy.Saria@ihs.gov mailto:Kelly.tadytin@ihs.gov https://www.ihs.gov/ihm/pc/part-5/p5c36/

III. Scheduling

Travel to the field is conducted by charter air, commercial air (airlines), General Service Administration (GSA) ground (government car/van), and privately owned vehicle (POV) ground methods. All are governed by the Federal Travel Regulations and/or IHS policy (Aviation Management and Safety; IHS Manual Circular 2010-01) and require the issuance of travel orders.

A. Air travel

All air travel for routine Temporary Duty (TDY) field visits is scheduled by the Field Operations Coordinator based upon a template developed in collaboration with the department chiefs or their designee (Department Flight Coordinator) and the field clinics.

This template represents a functional aggregation of PIMC requirements, field SU requirements, and cost efficiency. It is revised as needed and circulated to the Department Flight Coordinators. These flights are published as a monthly schedule and are available for review on any computer terminal with PIMC RPMS access. The Flight Schedule is developed approximately six weeks in advance of the first flight of the month based upon the Flight Template and vetted through the Department Flight Coordinator. Changes to the flight schedule may occur and are communicated immediately to all stakeholders as described below.

PIMC Flight Operations is involved in all chartered air flights, but does not participate in the arrangements for scheduled air carrier flights for Continuing Medical Education (CME) or other ad hoc administrative function.

B. Ground travel

Ground travel using GSA vehicles is scheduled by the transportation office, but published along with the air travel using the Flight Schedule software (see below).

C. Monthly schedule

The Field Operations Coordinator prepares the monthly flight schedule approximately two weeks prior to the first flight of the month. This draft schedule is based upon the template and previously requested changes. It is circulated to the Department Flight Coordinators who make corrections and changes. It is then entered into the shared Outlook calendar and made available to the Department Flight Coordinators.

The flight schedule follows a recurring template, but is necessarily dynamic to suit the needs of the departments and the field SU’s. If these changes go undetected, there can be significant negative impact on patient care and flight operation efficiency and cost. For this reason, several mechanisms in the scheduling process are designed as error traps. For these safeguards to work everyone in the loop must be aware of their role. Strict adherence to these responsibilities is a contingency for use of PIMC flight operations.

Safeguard 1:

The draft flight schedule is circulated to the Department Flight Coordinators for approval, changes, or corrections. In the absence of a prompt response to the Field Operations Coordinator, tacit approval is assumed and the schedule is published. Only an approved schedule is presented to the traveling staff.

Safeguard 2:

All traveling staff must check their monthly schedule for completeness and accuracy one week in advance of their first flight for the month using the shared Outlook calendar. This is a quality check for Safeguard 1. One week is required to allow sufficient time to make corrections without loss of efficiency or options for rescheduling.

The Field Operations Coordinator has the responsibility of maintaining the accuracy of the flight schedule, but this requires the active cooperation of the Department Flight Coordinators and travelers. It is critical that all travelers participate in step two above. All changes needed after the flight schedule is published must be communicated immediately to the Field Operations Coordinator by the Department Flight Coordinator using email (Outlook email), or by the traveler with a Cc to the Department Flight Coordinator.

Notification by phone may also be used, but does not replace the written notification by email. For changes that occur, 48 hours or less from the scheduled date/time of the flight notification of the Field Operations Coordinator must occur by both email and phone (602- 263-1677). Confirmation of the successful completion of the requested flight schedule changes will be made by e-mail, so failure to receive this confirmation signals the need for repeat call and/or vMail to the Field Operations Coordinator.

IV. Flight/Trip Policies

A. Trip refusal

The traveling public generally accepts flying by scheduled airline as safe and reasonable. For a variety of reasons, travel by on-demand charter aircraft carries a small but measurable excess risk as compared to airline travel. We accept this risk because it is very small and it is the only way we can operate an effective and cost efficient field practice. Because there is a small risk, and because this less common form of air travel can be associated with emotionally based concerns, IHS policy provides the traveler with several special considerations. One of these is the right for a traveler to refuse a flight at any time, for any reason, without the need to defend his/her decision at the time of the event. If a flight is rejected, the traveler must submit their reasons for refusing to fly in writing to their immediate supervisor and the Field Operations Coordinator. This policy is intended to protect a traveler from a flight that he/she feels is unsafe for any tangible or perceived reason. It does not allow frequent or blanket refusal of flights. Charter flights are the primary method of travel to SU’s not served cost effectively by an airline. Obvious exceptions are nearby clinics such as Sacaton and Fort McDowell where ground travel is used. Other exceptions to this are unusual and hinge upon issues of cost efficiency and convenience to PSU. All PIMC/PSU staff with jobs that make them eligible for field travel have a Position Description that includes this field travel and the associated air travel. A provider who has TDY responsibilities in the field covered by this PD language is expected to use the charter aircraft as a contingency of employment. Exceptions must be expressly requested and granted in writing by the Department Chief, appropriate Clinical Director, and PIMC Chief Medical Officer.

B. Departures

a. Baggage It is often necessary for passengers to bring equipment, supplies, or other baggage to perform their duties in the field. Our aircraft have a limited capacity for weight and bulk of baggage. This is particularly true of trips that have a high passenger loading. All travelers are encouraged to keep this in mind when planning for the trip, and limit their baggage to only that necessary for the field trip. If baggage capacity is exceeded for a particular trip, the least essential items will be offloaded prior to departure. A related issue is distribution of the baggage. Weight distribution is an important technical consideration of every flight and the pilot may need to place baggage at a location dictated by weight and balance calculations.

b. Departure time The published travel schedule includes departure location and time. This time represents the time that all passenger and baggage loading is complete, the door is closed, the passengers are briefed, and the engine is started. All travelers must arrive with enough lead-time to load their baggage, tend to personal needs, and find a seat in the aircraft. All travelers should be aware that our departures occur during rush hour street traffic and plan accordingly. If a traveler experiences an unanticipated and unavoidable delay, he/she should immediately call the PIMC operator or the Field Operations Coordinator. If practical, the flight will wait for the late passenger. Passengers with unannounced late arrival should expect the flight to depart without them. Once the aircraft engine has started and the pilot has begun taxing or has received taxi clearance from Air Traffic Control the aircraft will not return for a late passenger.

C. In-Flight The aircraft we operate have less seating space per passenger than airliners and sometimes the seating is cramped and the proximity of the passengers very close. All travelers should be especially mindful of their fellow passengers and demonstrate courteous and thoughtful behavior.

The pilot in command is held by Federal regulations to be the final authority in the aircraft, and passengers are specifically prohibited from interfering with the performance of his/her duties. Failure to follow the pilot’s instructions is generally interpreted to be a violation of these Federal Aviation Regulations, and may make violators subject to harsh consequences including fines and imprisonment. Therefore, all travelers are cautioned to heed any instructions given by the pilot.

The ambient noise level in our aircraft can contribute to fatigue and even hearing loss if unprotected exposure is prolonged. Passive noise attenuators are available from the transportation desk, Audiology Section of the Ear, Nose, and Throat (ENT) Department, and Field Operations Coordinator. Although the use of these protective devices is not mandatory, it is highly recommended.

D. Return

Return time There is no fixed time for return, although a target departure from the field is 1400-1500.

The earlier time in this range is established for linked flights, so that the subsequent links can be served by 1500. This will usually result in a return to Phoenix by 1600-1630. Early and late days occasionally occur based upon the specific site served, patient scheduling, no-show rate, and weather.

Return preparation Return planning begins upon arrival at the field. All travelers are expected to meet their TDY responsibilities in a timely manner. The reasons for this are cost and safety. Part of the cost of the trip is the “hold time” or time spent with the aircraft waiting for the return. Another reason for leaving the field as soon as practical within the limits described in IV.D.1. is weather. Occasionally, severe weather will develop unexpectedly and require a hurried off-schedule departure, making efficiency and productivity earlier in the day very important.

A related issue is communication between the passengers. It is not uncommon for a single flight to have multiple providers at two or even three locations. It is unusual for everyone to complete his or her duties at the same time. It is imperative that no one leaves the facility or moves to a location that is not communicated to all the other travelers. If a traveler wishes to pursue a non-duty activity when his duties are complete, he/she must contact the remainder of the team to determine if there is sufficient time remaining before departure.

He/she must also inform the team of where and for how long this activity will take. A return flight must not be delayed by non-duty activity. This is a good practice from both a courtesy and operational efficiency vantage. This is also critically important if a hasty departure is required due to weather.

E. Trip Documentation

The activity conducted at the field visit must be documented by every traveler using the TRIP software package available from any RPMS terminal or computer. The TRIP menu selection is located in the secondary menu for every employee who travels to field SU’s. It can be selected by typing TRIP from the initial prompt after logon. When the TRIP selection is made a series of data fields are presented for completion by the traveler. It is the responsibility of the Department Flight Coordinator or Department Chair to ensure that the TRIP reports are completed by each traveler.

TRIP software menu selections and options

FIELD ENTRY OPTIONS

Trip date:

Facility visited:

Purpose of trip: Case consultation

Clinic Conference Continuing Ed Presentation Inspection

No cli- see comment No clin- we cancl (clinic canceled by us) No clin- SU cancl (clinic canceled by them) No landing- wthr No takeoff- wthr Other- see comment QA review

In-service topic: (free text entry of lecture topic) Mode of travel: POV (privately owned vehicle)

GOV (government owned vehicle) REN (rental car) RENA (rental aircraft) CHA (charter aircraft) COM (commercial aircraft) None (used for canceled trips)

Patients scheduled Patients seen Inpatient Consults Case consultations (hallway consults or discussions about a case with SU staff when no visit note is completed) Surgeries/Procedures (number of surgical cases performed on-site; types of surgery should be entered in the comments sections) Surgery cases scheduled (for PIMC) Consults scheduled (number of cases scheduled for f/u or further evaluation at

PIMC)

Comments (free text entry of anything relevant not contained in the other field)

F. Trip Changes/Cancellations

Every effort is made to maintain the flight schedule as published. However, circumstances arise that may result in changes in the passenger manifest, or cancellation of a trip segment, one or more passenger seats, or even the entire trip. When this cannot be avoided the Field Operations Coordinator, Department Flight Coordinator, and passengers must act quickly to mitigate inconvenience and costs.

Air Charter Vendor Cancellations or delays are communicated immediately to the PIMC Field Operations Coordinator who then ensures timely communication to passengers and the field. Efforts are made to make cancellations at the earliest point in the trip as possible while still providing the best opportunity for salvaging the trip by equipment changes, reroutes, etc.

Department Flight Coordinator Cancellations/reschedule/passenger changes should be communicated as soon as the need is recognized. This is to provide maximum opportunity to optimize equipment and route efficiencies, minimize inconvenience to the field, and ensure conformance with FAA and contractual requirements. This may be done verbally to expedite the process, but should always be accompanied by a written request sent by e-mail to the Field Operations Coordinator.

Passenger Trip cancellations by the passenger should only be done when there is insufficient time to complete the process through the Department Flight Coordinator. This usually will be because of an unexpected circumstance that has occurred after normal duty hours on the day before a flight. For afterhours notification, or when the Department Flight Coordinator cannot be reached, the PIMC Field Operations Coordinator should be contacted immediately by phone (602 263-1677) and followed up with an e-mail message (randy.saria@ihs.gov) that includes the reason for the cancellation and request for rescheduling the trip.

G. Communications

Communications during a trip can be difficult and the method and route of contact variable.

The PIMC Switchboard (602-263-1200) is the first point of contact for communication with any member of the trip team, e.g. passengers, flight crew, flight operations.

In addition, the Field Operations Coordinator can be contacted at any time to facilitate resolution of any problem, including communications. The Field Operations Coordinator should be the first point of contact for all communications related to flight operations (randy.saria@ihs.gov, 602 263-1677).

V. Complaints

The Field Operations Coordinator is responsible for investigating all complaints by passengers, air taxi vendors, or pilots. The Field Operations Coordinator will make a final assessment following this investigation and seek an appropriate remedy. The outcome of the investigation and resolution of the complaint will be communicated to the Department Chair, Department Flight Coordinator and passengers involved. Depending upon the nature of the complaint and the investigation reporting may extend further to include all the flight coordinators, passengers, and PIMC in Phoenix Area Office administrative staff.

Any passenger who manifests a trend of behavior that is in violation of the guidelines described above is subject to suspension of flight privileges by the Field Operations Coordinator or Chief of Support Services.

All customers of the PIMC Flight Operations are encouraged to offer comments and suggestions for improvement of our services. Our goal is safe, comfortable, timely, and cost effective transportation of PIMC staff, and we are eager to improve our service to you.

VI. Recognition

All commissioned officer staffs that make regular flights during a six-month period in aircraft with ten or fewer seats are eligible for the IHS Hazardous Duty Award. The Field Operations Coordinator will initiate this award upon the notification by the Department Chief or Department Flight Coordinator that a traveling staff has met the requirements.

mailto:randy.saria@ihs.gov mailto:randy.saria@ihs.gov