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Safety Cultures in EMS Agencies Vary Widely, Pitt Study Shows

PITTSBURGH, Sept. 2, 2010 – A survey of emergency medical services (EMS) agencies from across the country found wide variation in perceptions of workplace safety culture—providing a tool that might point to potential patient safety threats, according to researchers at the University of Pittsburgh School of Medicine.

The study, to be published in the October/December 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.

About the University of Pittsburgh School of Medicine

As one of the nation’s leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1997 and now ranks fifth in the nation, according to preliminary data for fiscal year 2008. Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region’s economy. For more information about the School of Medicine, see www.medschool.pitt.edu.

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