Safety cultures in emergency medical services agencies vary widely, study finds

The study, to be published in the October/December 2010 issue of Prehospital Emergency Care and now available online, analyzed survey results from 61 EMS agencies in the U.S. and Canada. Researchers adapted a survey used in other health care settings to measure paramedic and emergency medical technician (EMT) perceptions of safety climate, teamwork, stress recognition and other components of workplace safety culture.

"While others have characterized safety culture in ambulatory care, the intensive care unit and other in-hospital settings, this is one of the first studies of its kind in the high-risk EMS environment. This study helps us begin to know how safe EMS care is -- and how widely safety cultures vary from agency to agency," said P. Daniel Patterson, Ph.D., EMT-B, assistant professor of emergency medicine at the University of Pittsburgh School of Medicine and lead author of the study. His comments come on the heels of another fatal helicopter ambulance crash in Arkansas, where three crew members, including EMS personnel, were killed.

Notably, the researchers found that air-medical EMS agencies tended to score higher across all six domains of safety culture than did ground-based agencies. Most of the EMS agencies participating in the study were private, rural, ground units employing fewer than 50 people. Most respondents were men who were full-time career employees of the agencies. The mean score on safety climate, one of the domains studied, was highest in agencies with fewer employees, lower annual patient contacts and higher proportions of acute patients.

Dr. Patterson emphasized that there is no common mechanism for classifying and reporting errors and adverse events in EMS. "The study provides benchmarking data for EMS agencies and a reliable and valid tool that EMS officials can use to evaluate safety within their agencies. We continue to collect data and report on variations through our network of EMS agencies affiliated with the EMS Agency Research Network," said Dr. Patterson.

The study was supported by grants from the MedEvac Foundation International and the Pittsburgh Emergency Medicine Foundation. During the study, Dr. Patterson was supported by the Emergency Medicine Patient Safety Foundation and a Society for Academic Emergency Medicine Patient Safety Research Fellowship.