Emergency Medical Services Safety Research Articles

Psychometric evaluation of the Persian version of Emergency Medical Services- Safety Attitudes Questionnaire (EMS-SAQ)

AimThis study aimed to conduct a psychometric evaluation of the Persian adaptation of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ).MethodsIn this cross-sectional study, the validity and reliability of the EMS-SAQ were assessed among 484 Iranian pre-hospital emergency department employees between February and June 2023.ResultsFive factors were extracted namely safety climate, teamwork, job satisfaction, stress management, and working conditions with explained 38.75% of the total variance. The goodness of fit indexes confirmed the model (χ2 = 409.031, DF = 196, χ2 /df = 2.087, CFI = 0.900, IFI = 0.901, PCFI = 0.763 and PNFI = 0.701, and RMSEA = 0.069 [CI90% 0.059–0.078]).ConclusionThe Persian version of the SAQ-EMS, comprising 22 items across five factors, demonstrated good validity and reliability. It is recommended to undertake qualitative studies focusing on the concept of patient safety in pre-hospital settings, considering diverse contexts and cultural nuances to develop more robust assessment tools.

Safety climate perceived by pre-hospital emergency care personnel-an international cross-sectional study.

Improving patient safety is one of the most critical components of modern healthcare. Emergency medical services (EMS) are, by nature, a challenging environment for ensuring patient safety. It is fast-paced, physically dangerous, and highly stressful, requiring rapid decision-making and action. This can create risks not only for patients but also for employees. We assessed variations in perceptions of safety culture in prehospital emergency care among an international sample of paramedics and nurses. The Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) was used for the study. The instrument measures six domains of safety culture in the workplace: teamwork climate, job satisfaction, safety climate, working conditions, stress recognition, and perceptions of management. A total of 1,128 EMS from 9 countries participated in this study. Safety Climate was 81.32/100 (SD 6.90), Teamwork Climate 84.14/100 (SD 8.74), Perceptions of Management 76.30/100 (SD 10.54), Stress Recognition 89.86/100 (SD 5.70), Working Conditions 81.07/100 (SD 9.75), and Job Satisfaction 70.71/100 (SD 7.21). There was significant variation in safety culture scores across countries for teamwork climate (TWC), working conditions (WC), and job satisfaction (JS). Among the individual variables (age, gender, level of education, and work experience), variations in safety culture scores were unaffected by age, gender, or work experience. Organizational characteristics: employment status and position type were linked to significant variations in safety culture domain scores. Participants' perceptions of the patient safety climate were not particularly satisfactory, confirming that there is still a need to develop a culture of patient safety in prehospital emergency care.

Attitudes Towards Patient Safety in Pre-Hospital Emergency Medical Staff in Mashhad, Iran

Background & Aims: Patient safety is an important component and one of the main elements of quality in health care systems. The patient safety status among the pre-hospital Emergency Medical Staff (EMS) in Iran is unclear and there is almost no information about adverse complications. Assessing the current patient safety culture can be a starting point for improving safety attitudes among health care workers, including pre-hospital EMS who are at the forefront of managing patients in critical conditions. This study aims to survey the attitude towards patient safety among pre-hospital EMS in Mashhad, Iran. Materials & Methods: This descriptive cross-sectional study was conducted on 438 full-time pre-hospital EMS with at least 6 months of operational work experience in Mashhad city in 2019, who were selected by a census method. The assessment tool was the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ). The collected data were analyzed in SPSS v. 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t test, analysis of variance, and Pearson correlation test). The significance level was set at 0.05. Results: It was reported that 13.75% had a positive attitude towards patient safety. The mean total score of EMS-SAQ was 53.55±10.60. The most positive attitude was related to stress recognition (34.2%) and the lowest positive attitude was related to safety climate and perception of management (5.7%). There was no statistically significant relationship between any demographic characteristics and overall attitude towards patient safety (P>0.05). Conclusion: The patient safety culture of the pre-hospital EMS in Mashhad is not positive. This requires further research and also taking measures such as holding briefing sessions for managers and staff, increasing the number of staff, setting up an error reporting system, and including topics related to patient safety in the in-service training courses for the staff.

Exploring safety culture in the Finnish ambulance service with Emergency Medical Services Safety Attitudes Questionnaire

BackgroundEmergency Medical Services (EMS) is, by its nature, a challenging context that may create risks for both patients and employees. It is also known that an organisation’s safety culture has an influence on both patient and employee safety. Finnish EMS organisations lack knowledge of how their safety culture is perceived by their employees.AimThis study aims to test the psychometric properties of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) in a Finnish EMS setting. We also explore the connections between individual- and organisation-based characteristics and safety attitudes in the Finnish EMS.MethodsA cross-sectional survey study design was used. The EMS-SAQ was used to collect data via social media. The instrument measures six domains of workplace safety culture: safety climate, teamwork climate, perceptions of management, job satisfaction, working conditions and stress recognition. The 5-point Likert scale was converted to a 100-point scale and mean ≥ 75 was dichotomized as a positive. Confirmatory factor analysis (CFA) was carried out to validate the EMS-SAQ in a Finnish setting. Other results were analysed by using non-parametric tests.Results327 responses were included in the analysis. CFA showed that the total EMS-SAQ model had acceptable goodness-of-fit values in the Finnish EMS setting. Total mean scores for each safety culture domain were identified non-positively (mean score < 75); safety climate 60.12, teamwork climate 60.92, perceptions of management 56.31, stress recognition 64.55, working conditions 53.43 and job satisfaction 70.36. Higher education was connected to lower job satisfaction and the teamwork climate within the individual characteristics. All organisation-based characteristics caused at least one significant variation in the safety culture domain scores. Working area significantly affected (p < 0.05) five out of the six safety culture domain scores.ConclusionsThe EMS-SAQ is a valid tool to evaluate safety culture among the Finnish EMS organisations; it offers a novel method to evaluate safety and patient safety within the Finnish EMS organisations. According to the findings, the organisation-based characteristics more likely had an impact on safety attitudes than did the individual-based characteristics. Therefore, it is suggested that the Finnish EMS organisations undertake safety culture development at the organisational level.

Evaluating Safety Culture Changes over Time with the Emergency Medical Services Safety Attitudes Questionnaire

Introduction The correlation between patient outcomes and the safety culture in healthcare organisations draws special attention to tools that can measure safety culture in such organisations. One of the advantages of such tools is their ability to identify changes in safety climate, which can support healthcare organisations in detecting and understanding trends, which might have otherwise been overlooked. Objective To evaluate the ability of a standard survey to capture long-term safety climate changes in pre-hospital care. Methods The previously validated Emergency Medical Services Safety Attitudes Questionnaire was administered in one regional base hospital program, which delegates to six pre-hospital emergency care services. The survey was administered over two consecutive years, thus allowing us to measure safety climate changes over time. Results Significant differences were found between the first and second years of the survey in specific services. Conclusions While we cannot identify the specific causes for the change in scores in the various services between the two survey years, we can draw some inferences. We suggest that the small changes that tend to reflect a consistent change across all services are the result of training and educational initiatives, while greater changes in some of the services reflect a change in the attitude of the paramedics to the service, driven by changes in operational procedures within the service. Our findings demonstrate that the questionnaire can capture safety climate changes over time in pre-hospital emergency care.

Professional environment and patient safety in emergency departments

The purpose of this study was to examine nurses' and physicians' perceptions of professional environment and its association with patient safety in public emergency departments in Cyprus. A total of 224 professionals (174 nurses and 50 physicians) participated (rr = 81%). Data were collected using the “Revised Professional Practice Environment” (RPPE) instrument and the Safety Climate Domain of the “Emergency Medical Services Safety Attitudes Questionnaire” (EMS-SAQ). The mean overall score of RPPE was 2.79 (SD = 0.30), among physicians 2.84 (SD = 0.25) and nurses 2.73 (SD = 0.33) (P-value = 0.07). Statistically significant differences were observed between the two study groups regarding “staff relationships”, “motivation” and “cultural sensitivity” (P-values < 0.05). No significant differences were observed as regards EMS-SAQ (3.25 vs. 3.16 respectively; P-value = 0.28). All 8 components of the RPPE exhibited significant association with patient safety. Linear and stepwise regression analyses showed that “leadership” explains 28% of the variance of safety. This relationship suggests improvements in professional environment with the ultimate goal of improving patient safety.

The Emergency Medical Services Safety Champions

The overarching mission of prehospital emergency medical services (EMS) is to deliver lifesaving care for people when their needs are greatest. Fulfilling this mission is challenged by threats to patient and provider safety. The EMS setting is a high-risk one because care is delivered rapidly in the out-of-hospital setting where resources of benefit to patients are limited. There is growing evidence that safety culture varies widely across EMS agencies. A poor safety culture may manifest as error in medication, back injuries, and other poor outcomes for patient and provider. Recently, federal and national leaders of EMS (ie, the National Highway Traffic Safety Administration) have made improving EMS safety culture a national priority. Unfortunately, few initiatives can help local EMS leaders achieve that priority. The authors describe the successful EMS Champs Fellowship program, supported by the Jewish Healthcare Foundation, designed to train EMS leaders to improve safety for patients and providers.

Another Look at the Emergency Medical Services Safety Report

Another Look at the Emergency Medical Services Safety Report