Integrating Multidisciplinary Reviews of Fatalities Into a High-Performing Air Ambulance Service

Abstract

Advanced prehospital care delivered by air ambulance services in the United Kingdom aims to reduce preventable trauma deaths by bringing hospital-level interventions directly to patients. Despite these efforts, a significant proportion of patients still die in the immediate phase, and current learning frameworks focus predominantly on identifying errors rather than examining all fatalities for system-wide improvements.

This paper explores the potential of integrating multidisciplinary approaches, particularly clinicopathological correlation (CPC) meetings, into high-performing air ambulance services to enhance learning from every death. By including autopsy pathologists alongside clinicians, CPC meetings provide a robust platform to correlate prehospital findings with definitive postmortem results, improving diagnostic accuracy, clinical reasoning, and professional development. They also foster interprofessional collaboration, support clinician well-being by providing closure, and strengthen patient safety through contextualized learning beyond fault finding.

Barriers include limited data sharing, coronial processes, and inconsistent governance across independent air ambulance services. However, the successful implementation of CPC multidisciplinary team meetings demonstrates significant educational and systemic benefits, driving innovation, and quality assurance. We propose that all high-performing air ambulance services should adopt structured, regular CPC meetings with pathologist involvement, thereby embedding learning from every fatality as a cornerstone of governance, resilience, and future improvements in care.