Almost accredited

MJ Brickey asks why CAMTS offers ‘conditional accreditation’ and EURAMI gives ‘provisional accreditation’ and how they differ
Catch 22
The Commission on Accreditation of Medical Transport Systems (CAMTS) added conditional accreditation to its policies and procedures more than a decade ago, but only awarded its first conditional accreditation in 2016, granting the status to US-based Air EMS of Tulsa for its fixed-wing and medical escort services.
The body created the category as a way to assist start-up medical transport companies to get themselves out of a legislative Catch-22 situation. While CAMTS requires companies to have been in operation for a year before they apply for standard accreditation, some US States require companies to be CAMTS-accredited as soon as they begin operations. “Which CAMTS asked (the government) not to do,” CAMTS Executive Director Eileen Frazer stated, “because when the government requires accreditation by a specific agency, it puts that agency in a potentially litigious position, because we cannot accredit something that hasn’t happened yet.”
She said conditional accreditation is not full accreditation, is only offered to new companies and can only be awarded once. “Our whole purpose is to assist programmes in developing and improving,” she said. “Conditional accreditation means the companies are developing their policies and practices by following the standards, and that the company is going in the right direction. After four months of business, they can apply for the conditional accreditation. We cannot award full accreditation until we have more information on quality and safety management, training, and have a year of statistics.”
The application process for full CAMTS accreditation takes four to six months on average. “Conditional accreditation lasts a year from the date that they achieve conditional status, but they must submit a programme information form (PIF) if they want full accreditation, or the accreditation will expire,” Frazer explained. 
CAMTS will not accept the PIF for full accreditation until a company has been in business for a year. Frazer commented that it generally takes a company a full year to figure out the range of care they will be providing to the area of service. “For example, some rotor-wing programmes start off responding to only interfacility transports, and then find they are needed to respond to scene transports, therefore, changing their scope of service,” she said.
CAMTS extends the opportunity for conditional accreditation to all new companies, but thus far, companies not in a US State that requires immediate accreditation have chosen to wait out the one-year CAMTS requirement for full accreditation and then submit the PIF.
CAMTS has been an accrediting organisation since 1990, the European Aeromedical Institute (EURAMI) since 1992, and National Accreditation Alliance Medical Transport Applications (NAAMTA) since 2009. US states’ legislation calling for companies to be CAMTS accredited came before NAAMTA established. However, a portion of the several states that historically required CAMTS accreditation have now opened up to NAAMTA. Colorado is currently the only state to have opened up all three including EURAMI, although other US companies within the other 49 states choose to be EURAMI accredited.
The terms may sound similar, but CAMTS’s ‘conditional accreditation’ is not to be confused with the ‘provisional accreditation’ that EURAMI gives after companies go through the full accreditation process. “EURAMI does not award a conditional accreditation,” the Institute’s managing director Andrew Wither confirmed. “We do offer provisional, but it is not the same as CAMTS conditional accreditation.”
The grading is granted to a company to give it more time to meet compliance after falling short of the accreditation standards, but meeting a predominance of them.
“Provisional accreditation is given for only a six-month period,” Wither said. “[It’s] given after a company has gone through the accreditation process, but failed to meet the minimum pass rate.”
There has been only one example where a company was granted provisional accreditation and then had it revoked. Wither explained: “In December 2015, Bangkok Dusit Medical Services & Bangkok [Helicopter] Services received their accreditation certificate with the additional requirement that a one-day onsite visit must take place. The purpose of this one-day visit was to ensure that the post-audit updates provided have been implemented and understood by the staff. Unfortunately, the Bangkok Dusit Medical Services & Bangkok [Helicopter] Services board refused to comply with this requirement.” He said that because the board refused this site visit, the company was no longer compliant with the EURAMI standards, hence their accreditation was revoked ‘with immediate effect’. AMR alerted EURAMI that as of June 2017, the organisations’ websites ( -bdms and continued to suggest they were EURAMI-accredited.
All or nothing
NAAMTA also has a minimum period before a company can begin the accreditation process. “We require that companies be in service for six months before they apply for full accreditation,” NAAMTA executive director Roylen ‘Griff’ Griffin said. “If they apply just after six months of service, by the time they go through the process, paperwork, and an audit, they have usually been in service about a year and a half.”
Griffin said NAAMTA does not offer conditional or provisional accreditation and sets a bar with criteria and standards that ensure the quality of patient care, management, and compliance for safety that the applying medical transport company must meet. He added: “We do not see conditional accreditation as a benefit to the safety and well-being of the patients being transported. You are either meeting our standards and are accredited, or you are not.”