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Quest Air Logistics: 5,000 Patients Onboard

In the fight against COVID-19, flying medical tests to Quest Diagnostics’ labs every night is more critical than ever.

Moonlight is reflected on the slick tarmac at Chicago DuPage Airport. It’s 1 a.m. A pilot carries two green coolers toward a waiting car. After handing the coolers to the driver, the pilot crosses the ramp, back to his Pilatus PC-12 and prepares to take off again. He has more stops to make tonight.

For Quest Diagnostics, handoffs like this take place in 63 cities across the country every night. The company’s 4,000 drivers have spent the day picking up medical specimens from hospitals and doctors’ offices and bringing them to airports, where the coolers are flown overnight to Quest’s three dozen labs.

“The turnaround time for these tests requires the specimens be delivered to our labs by 2 a.m., so the results can be ready for doctors and patients by 8 a.m.” explains Scott Borton, Quest’s senior director of national air logistics. “It’s not necessarily a glamorous pilot job, but we all understand the importance of the role we play, now more than ever.”

With 24 airplanes, Quest Air Logistics flies medical test samples from four bases: in Dallas, Kansas City, Atlanta and the aviation hub in Reading, PA, where the company is headquartered.

When the pandemic erupted, Quest’s fleet gathered the equipment and supplies to rapidly set up COVID-19 testing. At the time, many commercial flights were being cancelled. Soon, Quest’s fleet was transporting COVID-19 test samples, along with their usual specimens. By August, Quest had performed 14.4 million COVID-19 tests, and had the capacity to process 350,000 per day.

“We’re still increasing our COVID testing capacity,” said Bob Severini, executive director of logistics. “Normally, we work with doctors and hospitals. During the pandemic, we also are partnering with retailers like CVS. This is a national medical emergency, and we’re not stopping.”

“With COVID, we are on the front lines, but everything we do impacts patient care. We’re not just hauling coolers. Every specimen is a life.”

George Lloyd Senior Director of Logistics, Quest Diagnostics

16 Runs Every Night

Business continuity is fundamental to Quest Air. For example, when a hurricane shuts down airspace, the Quest airplanes are the last out, and the first back in after the weather clears.

To safely maintain that operational uptime, four schedulers in Quest’s Atlanta dispatch center continually monitor weather across the country. A team of 25 maintenance technicians spread across the company’s four bases can respond to AOG events within hours. Each base essentially has a backup airplane on standby.

Quest operates three different aircraft types for medical transport: Embraer Phenom 100s, Pilatus PC-12s and Beechcraft Barons. The nine PC-12s are the workhorses, each flying 100 hours per month. The piston-powered planes are used on legs under 100 miles, and the jets fly longer routes, such as over the Rockies.

The routes are fairly consistent, night after night. The longest one starts in Reading, involves multiple stops across the Northeast, and returns to PA in the early morning. With the exception of a Falcon 2000 for employee travel, all aircraft are scheduled weeks in advance. Quest Air flies nearly 18,000 hours a year.

“With COVID, we are on the front lines, but everything we do impacts patient care,” said George Lloyd, senior director of logistics. “We’re not just hauling coolers. Every specimen is a life, and we take that very seriously. In that airplane with you, you have could have 5,000 patient lives.”

Multiple Layers of Safety

Quest operates all medical flights single-pilot, and relies on multiple policies to ensure safety. The company has renewed its Stage 3 IS-BAO registration and participates in an FAA Aviation Safety Action Program. Quest Air is Part 135 certified.

“These safety programs provide solid lines in the sand,” explained Chief Pilot Andrew Alvine. “And we exceed Part 135 duty limitations.”

All of Quest’s aircraft are equipped with tools to further enhance safety, including surveillance radar, WAAS, weather uplinks, autopilots and TCAS.

On many longer runs, Quest pilots get some assistance from the operation’s second-in-command program. For years, this initiative has been useful in training new recruits while enhancing safety.

With night flying, managing sleep is a big part of the job. Pilots almost always know their schedule six weeks in advance, so they can prepare to adjust their sleep schedules as they rotate through Quest’s 13 scheduled routes. This ensures that everybody takes turns flying the five-hour runs, the 12-hour runs, and everything in between.

While each pilot is responsible for being fit for duty, “we put a lot into fatigue education,” said Safety Officer Nicholas Pagerly. “We do our own in-house fatigue awareness training, and in our monthly newsletters we always have information on fatigue.”

“This pandemic has not just changed Quest Diagnostics, it’s changed the world.”

Bob Severini Executive Director of Logistics, Quest Diagnostics

Active Communication

With 80 aviation personnel spread across four bases, clear lines of communication keep Quest Air moving, safely and reliably. The newsletters highlight safety issues and recognize pilots, maintenance technicians and schedulers who demonstrate “everyday excellence.”

Throughout the night, on-duty team members stay in touch via text, phone and email. “It’s a combination of everything,” said Dispatch Manager Matthew Barondick. “I might text a pilot to let them know a specimen driver is running late, and then email our laboratory that the plane is waiting for a driver.”

While flying a route, pilots can call in to troubleshoot any squawks.

Every day, the Quest Air leadership touches base at a 2 p.m. meeting.

“We look at the weather to see if there are any pinch points across the system,” said Pagerly. “If it’s snowing at a destination, do we go to an alternate airport, or send pilots out early to get them ahead of the weather? We try to alleviate a lot of that decision-making so pilots can focus on flying the airplane.”

Pilots concerned about weather are encouraged to join the 2 p.m. call and discuss any issues with the leadership. But the go/no-go call still is made by the pilot. That meeting is also where operational trends and safety issues are discussed.

“When you’re scattered around the country, the daily meeting is a good time to get staff input and focus on safety,” said Chief of Maintenance Frank Kerber. “We’re a humble group when it comes to learning from our mistakes.”

Differentiated Roles

Within the maintenance function, learning from experience and incorporating insights into policies falls to Chief Inspector Thomas Benn. But there are actually three maintenance leaders: the chief inspector, a director of maintenance (Howard Busch) and a chief of maintenance (Kerber).

“It’s a hybrid of a repair station org chart and our own,” explained Busch. “Frank manages day-to-day fleet readiness and AOGs. I do long-term planning, fleet operations, vendors and procurement. The chief inspector ensures regulatory and safety compliance.”

The maintenance technicians are not as specialized. Instead of each one focusing on a single aircraft type, they are jacks-of-all-trades. “We’re a versatile group,” said Kerber.

COVID-19: Quest Air’s Greatest Test

The outbreak of the pandemic was just as disruptive to Quest Air’s operations as it was to every other business – even as their medical testing mission was more critical than ever.

“Until this year, most of our runs were during the week, and the volume would drop over the weekend,” explained Scott Borton, Quest’s senior director of national air logistics. “With COVID-19, we’re operating seven days a week, just to keep testing moving.”

At the outbreak of the pandemic, most doctors’ offices across the country closed for non-essential procedures. That caused an initial dip of 40% in traditional testing. However, the surge in COVID-19 testing more than made up for the difference, and Quest’s diagnostic work has increased 7% overall thus far in 2020.

At the same time, Quest had to prioritize protecting its frontline workers. Logistics leadership made sure pilots and drivers had enough facemasks and hand sanitizer, and frequent virtual town halls were used to share health best practices across the company.

“This pandemic has not just changed Quest Diagnostics, it’s changed the world,” said Bob Severini, executive director of logistics. “With strong training and communication, we’ve been nimble and able to respond.”

Learn more about Quest Diagnostics at questdiagnostics.com.

Snapshot

Aircraft: Nine Pilatus PC-12s, nine Beechcraft Barons, five Embraer Phenom 100s and one Dassault Falcon 2000

Base: Headquartered at Reading Regional Airport (RDG), with remote bases in Gwinnett County Airport (LZU), Charles B. Wheeler Downtown Airport (MKC) and Dallas Love Field Airport (DAL)

Personnel: 35 pilots, 25 maintenance technicians, four schedulers and four administrative staff

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