BCEN Updates

CAMTS Standards Update: Transport-Specific Credentials Now Required for RNs

CAMTS Standards Update for Transport Nursing

In its 12th edition accreditation standards, which went into effect on January 1, the Commission on Accreditation of Medical Transport Systems (CAMTS) will require RNs working for a CAMTS-accredited program to hold a transport-specific advanced certification.

For transport nurses whose only advanced credential is the previously-accepted Certified Emergency Nurse (CEN) or CCRN, this will mean earning a CAMTS-accepted transport credential such as BCEN’s Certified Flight Registered Nurse (CFRN), which spans flight nursing care for patients of all ages, or the Certified Transport Registered Nurse (CTRN), for critical care ground transport of patients of all ages.

(Complete details, including the transition timeline, are on page 65 of the 12th edition CAMTS standards. Links to information and resources about CFRN and CTRN certification follow this article.)


Interview with CAMTS Executive Director Eileen Frazer

BCEN recently talked with CAMTS founder and longtime executive director, Eileen Frazer, RN, CMTE, about the importance of advanced certification in the transport environment and CAMTS’s leadership in promoting safety and high-quality care in the air and on the ground.

How did CAMTS come to be an early and staunch advocate for specialty certification for transport professionals including nurses?

Frazer: CAMTS accreditation is a voluntary process that promotes patient care and safety. Standards are written above and beyond state and local regulations to recognize and promote a higher level of care and safety.

What factors prompted the shift to transport-specific credentials being required for flight and ground transport nurses?

Frazer: We recognized and always required critical care and emergency nursing certifications but since transport nursing is such an autonomous environment, we felt the transport nursing certification met those special aspects of both air and ground transport nursing above and beyond the critical care and emergency nursing certifications.

What do you want RNs who might not be so familiar with CAMTS to know about the organization?

Frazer: CAMTS provides a blueprint for the knowledge, policies, and all aspects of transport by developing and revising standards to keep in step with current practices. Every discipline and profession involved in air and ground transports—including medical directors, nursing, paramedics, respiratory therapists, specialty nurses such as pediatrics, neonatal and high-risk OB, EMTs, communication specialists, pilots, ambulance operators, mechanics, and management—as well as operational policies and procedures are part of the standards.

Even if a service or program does not have an interest in applying for accreditation, the standards provide what is currently needed in a transport service.

CAMTS is made up of 21 nonprofit organizations, each represented on the board of directors, and all of which are dedicated to improving the quality and safety of medical transport services.
Today, under the aegis of CAMTS and CAMTS Global, there are approximately 200 accredited transport programs—spanning over 900 helicopters, over 200 fixed-wing aircraft, and over 660 ground ambulances—in 6 countries around the world (the United States, Canada, Saudi Arabia, Switzerland, Thailand and the United Kingdom).

With a specially trained cadre of site surveyors, CAMTS completes 60-65 new or reaccreditation applications every year and processes over 100 progress reports as operations correct deficiencies found during audits. Approximately 65% of applicants achieve accreditation upon their initial application.

Is there anything on the near-term horizon for CAMTS and CAMTS-accredited programs that you’d like to share, or anything about the future of transport care you are especially excited about?

Frazer: We recently published standards and accreditation for Mobile Integrated Health (MIH) because we feel this is the future of out-of-hospital care. Emergency transports will always be the basis of our service, but transport is also out-of-hospital care. The MIH scope varies greatly—from an EMT visiting a senior to make sure they are taking medications as prescribed, to home health RNs delivering care, to physicians examining patients by telemedicine. We see healthcare evolving through these capabilities to visit and care for patients in their homes to prevent unnecessary transports, trips to the ED, and admissions.

There were no national standards for MIH. CAMTS has been an established standards-setting organization for many years and is accredited by ANSI. Two years ago, we organized a committee of experts and developed standards. This January, we opened the process to accept applications for MIH accreditation. We have trained site surveyors and already have an applicant.

I was recently speaking at a conference, and attendees from hospitals, fire departments and ambulance services who are just beginning to develop their own MIH services were very eager to learn about the standards. As I previously stated, CAMTS standards can serve as a blueprint and guide for best practices, especially for those not familiar with this process or who are developing a new mode of transport or scope of care.

What inspires you? And what would you like to say to BCEN-certified nurses?

Frazer: I’m the kind of person who, when something isn’t right, I need to get in there and fix it. When I started going on flights, all I knew about aircraft was from watching M*A*S*H. There were no standards for civilian flight safety and care, which wasn’t the hospitals’ fault. But we knew that how you treat patients in the air, for instance, is totally different. That’s when I joined AAMS (then called ASHBEAMS), and we went to work to establish safety guidelines.

My advice is to get as much education and training as possible. Also, there is nothing that can replace being paired with more experienced nurses and paramedics. We learn a lot from those senior to us, and those outside our own discipline.


About Medical Transport Pioneer Eileen Frazer, RN, CMTE

In the mid-1980s, Frazer was an emergency room nurse—and later, a chief flight nurse—in Allentown, PA, and chaired the safety committee of what is now the Association of Air Medical Services (AAMS). The committee drafted criteria for peer review safety audits to address a growing number of air ambulance accidents. But Frazer and the committee felt the audits should be performed by an independent organization. So, in 1988-1989, Frazer did a feasibility study, modelling her proposed organization on the Joint Commission on Accreditation of Healthcare Organizations (today’s The Joint Commission), which accredited hospitals.

Eileen founded CAMTS as an independent, nonprofit organization and wrote many of policies and standards that guide the accreditation process. Her leadership, pioneering work and passionate commitment to safety has been recognized with the Jim Charlson Award for aviation/safety in 1991, the Marriott-Carlson Award in 2000 for outstanding contributions to the air medical industry, the FAA Safety Team’s Education Outreach Award in 2009, and the Airbus Helicopter Golden Hour Award in 2016.

Eileen’s new book, The Emergency of Helicopters and Hospitals: From Vietnam to Hospital Air Ambulances, just published in August 2022. She also coedited the 2012 reference book Safety and Quality Medical Transport Systems: Creating an Effective Culture and has published numerous articles.

Eileen lives with her pilot husband in the Pacific Northwest, where she cofounded the Cancer Treatment Transportation Fund to transport rural patients to and from their cancer treatments.


Transport Certification Info & Resource Links for Flight and Critical Care Ground Transport Nurses

BCEN is proud to offer reduced certification and renewal fees to members of the Air & Surface Transport Nurses Association and U.S. military active-duty service members, reservists and veterans on all initial certifications, retests and recertifications.