New emergency-focused health indicators build on SHS’s Best Practice KPI framework, helping maritime operators measure readiness, response, outcomes and learning when medical emergencies occur onboard.
The Seafarers Hospital Society (SHS) has developed a dedicated set of Key Performance Indicators (KPIs) surrounding medical emergencies onboard, expanding its wider Best Practice KPI work to address the specific challenges of responding to serious illness and injury at sea.
The KPIs provide a structured approach to assess how effectively maritime organisations prepare for, respond to and learn from medical emergencies. They recognise that effective emergency care requires more than having the right equipment and procedures in place: it also depends on timely assessment, clear escalation pathways, access to medical expertise ashore and the ability to review incidents and improve future responses.
Their development follows an extensive workshop in June, convened by SHS alongside medical experts from the International Maritime Health Association (IMHA) and International Maritime Health Foundation (IMHF) in response to emerging threats facing seafarers globally. The resultant emergency-focused indicators represent a development within its wider mission to promote a culture of care across the maritime sector and focuses specifically on the systems and capabilities needed when a medical emergency occurs onboard.
Dr Nebojša Nikolić, President of the Management Board at the IMHF, said: “From our perspective these KPIs provide a structured approach to measuring preparedness, response and recovery from medical emergencies at sea. By promoting continuous learning and evidence-based improvement, they support safer, more effective care for seafarers.”The proposed indicators span four progressive levels, from establishing essential capabilities and recording emergency incidents to assessing the effectiveness of responses and embedding continuous improvement. They cover areas including medical equipment inspections, emergency procedures, access to Telemedical Assistance Services (TMAS), time to first medical assessment, medical evacuations, emergency medical drills and post-incident reviews.
Together, these measures are intended to help ship operators move beyond simply confirming that arrangements exist, towards understanding how well those arrangements work in practice — and where improvements may be needed. From preparedness to continuous improvement Medical emergencies at sea present challenges, from delays to the arrival of shorebased medical help, the readiness and initial response of the crew, and the availability of onboard medical resources. The proposed KPIs reflect these realities by considering the emergency pathway as a whole: from preparedness and initial assessment through escalation, treatment, evacuation or shore-based care, and subsequent review and recovery.
“When a medical emergency occurs at sea, preparedness, timely decision-making, and effective communication can make a critical difference to a seafarer’s outcome. These KPIs provide a practical framework for helping maritime organisations assess not only whether the right systems are in place, but how effectively they work in practice. By learning from each incident and continually strengthening their response, we can help foster a culture in which seafarers’ health, safety and wellbeing remain at the heart of maritime operations. IMHA is pleased to have the opportunity to contribute to this initiative” said IMHA President, Sue Stannard.
The framework also recognises the importance of training, resilience, and support for crew members during and after a crisis. By incorporating measures related to emergency drills, refresher training, recovery support, and completed post-incident reviews, it encourages organisations to consider not only immediate medical outcomes but also lessons that can strengthen future preparedness.
Building on SHS’s Best Practice KPI programme
In 2023, SHS developed a Best Practice KPI Toolkit, which provides a four-level, progressive self-assessment framework designed to complement existing commercial and regulatory requirements while helping organisations identify priorities for improvement. The emergency-focused KPIs extend this approach into a more specific area of maritime health management, translating the principles of measurement, accountability, and continuous improvement into indicators relevant to medical emergencies onboard.
By providing a clearer structure for monitoring emergency preparedness, response and outcomes, SHS aims to support shipping companies, ship managers and ship owners’ in developing a more evidence-informed approach to seafarer health and safety.
The proposed KPIs are intended as a practical framework for self-assessment and improvement. Their value lies in helping shipping companies, ship managers and owners improve their current capabilities, identify gaps and take informed action to strengthen care available to their crew.
