Abstract
BackgroundWorkload is a major determinant of system performance and human well-being. This study aims to evaluate workload in prehospital emergency medicine on a single mission level and investigates influencing factors originating from medical scenarios, patient-provider interaction, EMS logistics and teamwork.MethodsIn a nationwide study, German paramedics were asked to evaluate single missions for perceived workload by completing the NASA Task-Load-Index (TLX). A variety of candidate variables were documented and tested for influence on the TLX through multivariate regression analysis.ResultsOne thousand three hundred sixty-one emergency missions were analysed. Global workload scored in medium ranges (Median TLX 41.00/100; IQR 24.25–57.50). 263 missions achieved very low (< 20/100) and 52 missions achieved very high (> 80/100) levels of workload. Severity of distress as indicated by the NACA score (delta TLX 2.71 per 1 NACA point), execution of invasive procedures (e.g. delta TLX 8.20 for intravenous access), obese patients (delta TLX 0.05 per 1 kg of weight) and aggression incidences (e.g. delta TLX 10.54 for physical aggression), amongst others, resulted in significant increases in workload. Good teamwork decreased workload by 2.18 points per 1 point on the Weller-Teamwork Measurement Tool.ConclusionDistinct factors result in significant increases in workload for EMS paramedics. Improvements in training for certain medical scenarios, strategies against aggression events and enhancements in EMS logistics - especially for the transfer of obese patients – should be implemented and tested for their presumably positive effect on workload, EMS performance and paramedics’ well-being.
Highlights
Workload is a major determinant of system performance and human well-being
Our study aims to assess the single-mission workload of Emergency medical services (EMS) paramedics during emergency runs by means of the National Aeronautics and Space Administration (NASA) task-load-index (NASA-TLX) [7]
To examine possible influencing factors on work-load, we explored a variety of candidate variables, comprising, amongst others, medical and organizational characteristics of emergency missions as well as exchanges with patients and perceived teamwork between paramedics using the teamwork measurement tool (TMT) by Weller [8, 9]
Summary
Workload is a major determinant of system performance and human well-being. This study aims to evaluate workload in prehospital emergency medicine on a single mission level and investigates influencing factors originating from medical scenarios, patient-provider interaction, EMS logistics and teamwork. Emergency medical services (EMS) aim for fast and accurate performance by their trained professionals in a multitude of scenarios. The human factor remains pivotal in patient care in spite of all pharmaceutical and technical advances. One major factor that human performance is dependent on is “workload”. It can be measured physiologically and/or subjectively for short-term single tasks as well as long-term assignments [2]
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