Interview: Matthew Baily, Chief Flight Paramedic for Life Lion Critical Care
Clinical care in the air: Matthew Baily tells AirMed&Rescue what got him hooked on HEMS and what keeps him excited about coming into work each day
Please could you explain the crew structure, fleet and operating regions of Life Lion Critical Care?
Penn State Health Life Lion Critical Care operates with a single pilot, flight paramedic and flight nurse for the majority of our mission profiles. Our program works closely with our associated academic medical center and children’s hospital to ensure regular and continuing training with our specialty patient populations. Our program also incorporates specialists into our team from our children’s hospital on high-risk or acutely ill pediatric patient transfers. This allows our team to bring more advanced capabilities to referring facilities, ensuring the highest level of care is being provided at bedside.
With two AS365 Dauphins and two EC155s from three bases, Life Lion covers a substantial portion of central Pennsylvania that includes portions of Perry, Juniata, Cumberland, Adams, York, Dauphin, Lebanon and Lancaster Counties. Life Lion Critical Care also provides the region’s only dedicated critical care ground assets.
How has your career evolution brought you to your current role as Chief Flight Paramedic?
My entrance into the air medical world was curiously accidental, but was certainly the best career move I have ever made. After completing my undergraduate degree, I stepped into the pre-hospital world as a paramedic and thoroughly enjoyed the pace, environment and variability. After a short time, I quickly saw the challenges facing EMS [emergency medical services] and stepped into leadership roles until ultimately serving as an executive director for an EMS agency in central Pennsylvania.
In looking for my next vocational challenge, I served as the director for a paramedic education program at a local community college, but quickly realized that the educational environment was not a strong fit for me. While pursuing my master’s degree, I had a chance encounter with a colleague in flight medicine who strongly encouraged me to apply to Life Lion.
The Life Lion air medical program had a storied reputation in my community and it was famously difficult to secure a seat in the program. They seemed ‘larger than life’ to most of the local EMS services and therefore I truly did not expect to be hired after applying. However, after a rigorous interview and selection process developed by the team at Life Lion, I (miraculously) was hired. Once in HEMS [helicopter emergency medical services], I found an amazing community of like-minded and dedicated professionals with a passion for bleeding-edge patient care. Put simply and like so many others in the field, I was hooked.
What does your role involve on a daily basis, and are two days ever the same?
No two days are ever the same in most emergency operations roles, and air medical is no different. I’m certain that the majority of my colleagues would agree that’s what keeps us excited about coming to work each and every day. My supervisory role focuses largely on day-to-day operational management of our clinical providers and our clinical equipment. I am also responsible for the capture and analysis of data needed to inform operational, business and clinical strategies for our agency. In addition to these functions, I still have the privilege to provide clinical care in the air and on our critical care ground assets.
Every day and every callout brings different challenges for the medical and flight crews; how do you ensure that you are always working together – what sort of training do you undertake as a cohesive unit, rather than separately as medical and flight crews?
This is a fantastic question, and one that we dedicate a gre
In order to operate safely and efficiently, there must be strong lines of communication laterally and vertically and extreme ownership by the entire team
at deal of time and energy to perfecting. Highly reliable organizations tend to fastidiously focus on failure points and communications in order to minimize risk and improve operations. In order to operate safely and efficiently, there must be strong lines of communication laterally and vertically and extreme ownership by the entire team. Some bases may operate with different capabilities, assets or challenges that need to be conveyed across the team membership. This necessitates consistent and thorough communications.
The nature of shift work makes it difficult to train as one collective unit; however, our competency-based simulation training takes place in teams.
What would you say is the most important piece of medical equipment that you carry onboard? Is there something that you’d never leave base without?
Our team has spent many years perfecting an ideal and comprehensive medical loadout to meet the needs of a wide variety of call types as well as the full spectrum of patient populations. Arguably the most important piece of medical equipment is our cardiac monitor.
That being said, I would also never leave base without my bag of adapters and specialty items. Air medical, by nature, encounters a wide array of differing health systems, proprietary equipment, proprietary connections and unique situations. Coming fully prepared with a full suite of adapters and connectors is vital to IFT [interfacility transfer] mission success.
How has the HEMS working environment changed for the better since you first started working in it? Do you think that the focus on the safety of the aircraft and crew is now balanced correctly with the need to reach the patient?
HEMS has certainly reaped the dividends of our focus on safety, safety culture and our ever-increasing clinical bedside capabilities; however, there are still improvements needed regarding the utilization of air medical resources. The ongoing decline of regional EMS transport capacity should not necessarily dictate the utilization of air medical resources. In some cases, air medical is chosen only after the patient has begun to clinically decline waiting on local ground transportation. Patients requiring a high level of care should not need to wait until there is clinical deterioration before transport is available; unfortunately, this has become a reality in many areas across the country.
Critical care transport is more than a platform; it is the presence of a talented, highly trained and capable team caring for a patient in transport
Thankfully, many programs are improving their capacity to reach patients by ground when a flight is not possible but a patient still requires urgent transportation to a higher level of care. From my perspective, I certainly believe that we have measures and industry expectations for safe flight operations in place; however, I believe we still have a need to reach our patients even when flight is not available. Critical care transport is more than a platform; it is the presence of a talented, highly trained and capable team caring for a patient in transport. Naturally there are many time-sensitive transports where rapid transit is a necessity; however, many patients simply need a dedicated team of critical care transport experts that can safely move them. Whether by air or ground, it is the critical care transport team that truly makes the difference for our patients.
Has the No Surprises Act (US law which became effective in 2022) changed the way Life Lion operates in any way?
The No Surprises Act has had no substantive impact on the way we operate. Since inception, we have been a nonprofit organization part of the Penn State Health Milton S Hershey Medical Center.
How has technology like virtual reality (VR) and artificial intelligence (AI) changed the way you train your crews, and do you think that such tech has the potential to change the way you practice medicine in the future?
We have not yet employed VR in our training regime; however, as the field expands and begins to offer more realistic and industry-specific training, we hope to incorporate this technology.
Artificial intelligence programs are of enormous potential benefit to any program. As AI capabilities grow, they can be utilized to evaluate our operations (medical and otherwise) to guide us in improved quality management, safety, clinical care and documentation. I believe that AI, very specifically, will have the capacity to descriptively and predictively augment the way we practice medicine and in some cases is already doing so. I suspect that, in the future, AI will rapidly challenge long-held but unsubstantiated beliefs and will shed light on areas where our industry must adapt to meet evolving needs and challenges.
What do you enjoy most about your job, and what do you find most challenging?
I love flying, technically complex clinical care, transport medicine, and working with a genuinely talented and focused team
Air medical just happens to exist at the intersection of several of my passions: I love flying, technically complex clinical care, transport medicine, and working with a genuinely talented and focused team. Managing an operational team in a dynamic environment always has its challenges, though a challenge is not necessarily negative in nature. A challenge is how we grow and become stronger; without a challenge, we quickly become stagnant and lose our edge. I believe that navigating the challenge itself, whether it be clinical or managerial in nature, is the most enjoyable aspect of my position.