Variation in emergency medical services workplace safety culture.
BACKGROUND
Workplace attitude, beliefs, and culture may impact the safety of patient care. This study characterized perceptions of safety culture in a nationwide sample of emergency medical services (EMS) agencies.


METHODS
We conducted a cross-sectional survey involving 61 advanced life support EMS agencies in North America. We administered a modified version of the Safety Attitudes Questionnaire (SAQ), a survey instrument measuring dimensions of workplace safety culture (Safety Climate, Teamwork Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition). We included full-time and part-time paramedics and emergency medical technicians. We determined the variation in safety culture scores across EMS agencies. Using hierarchical linear models, we determined associations between safety culture scores and individual and EMS agency characteristics.


RESULTS
We received 1,715 completed surveys from 61 EMS agencies (mean agency response rate 47%; 95% confidence interval [CI] 10%, 83%). There was wide variation in safety culture scores across EMS agencies [mean (minimum, maximum)]: Safety Climate 74.5 (min 49.9, max 89.7), Teamwork Climate 71.2 (min 45.1, max 90.1), Perceptions of Management 67.2 (min 31.1, max 92.2), Job Satisfaction 75.4 (min 47.5, max 93.8), Working Conditions 66.9 (min 36.6, max 91.4), and Stress Recognition 55.1 (min 31.3, max 70.6). Air medical EMS agencies tended to score higher across all safety culture domains. Lower safety culture scores were associated with increased annual patient contacts. Safety Climate domain scores were not associated with other individual or EMS agency characteristics.


CONCLUSIONS
In this sample, workplace safety culture varies between EMS agencies.
Patterson
P Daniel
PD
Department of Emergency Medicine and Center for Emergency Medicine of Western Pennsylvania, Inc, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA. pattersond@upmc.edu
Huang
David T
DT
Fairbanks
Rollin J
RJ
Simeone
Scott
S
Weaver
Matthew
M
Wang
Henry E
HE
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D015279:Organizational Culture; D017751:Safety Management; D014481:United States; D055815:Young Adult
Healthc Q. 2005;8 Spec No:32-8
16334069
Prehosp Emerg Care. 2009 Oct-Dec;13(4):451-5
19731156
Am J Med Qual. 2009 Sep-Oct;24(5):374-84
19528543
Qual Saf Health Care. 2010 Oct;19(5):e2
20211960
J Appl Psychol. 2000 Aug;85(4):587-96
10948803
J Appl Psychol. 1980 Feb;65(1):96-102
7364709
N Engl J Med. 2004 Oct 28;351(18):1838-48
15509817
Qual Saf Health Care. 2009 Jun;18(3):213-6
19468005
Jt Comm J Qual Saf. 2004 Mar;30(3):125-32
15032069
JAMA. 2009 Sep 23;302(12):1294-300
19773564
BMC Health Serv Res. 2006 Apr 03;6:44
16584553
Prehosp Emerg Care. 2005 Jan-Mar;9(1):2-7
16036820
Health Aff (Millwood). 2006 Mar-Apr;25(2):501-9
16522604
Qual Saf Health Care. 2003 Apr;12(2):112-8
12679507
Prehosp Emerg Care. 2010 Apr-Jun;14(2):187-93
20199233
Prehosp Emerg Care. 2010 Jan-Mar;14(1):95-102
19947873
J Gen Intern Med. 2007 Jan;22(1):1-5
17351834
Jt Comm J Qual Patient Saf. 2007 Nov;33(11 Suppl):7-18
18173162
Crit Care Med. 2003 Mar;31(3):956-9
12627011
Prehosp Emerg Care. 2006 Jan-Mar;10(1):21-7
16418087
Prehosp Disaster Med. 1997 Oct-Dec;12(4):242-9
10179201
Qual Saf Health Care. 2005 Oct;14(5):364-6
16195571
Sentinel Event Alert. 2008 Jul 9;(40):1-3
18686330
Qual Saf Health Care. 2005 Aug;14(4):231-3
16076784
Ann Emerg Med. 2003 Dec;42(6):721-8
14634593
Crit Care Med. 2007 Jan;35(1):165-76
17110876
Prehosp Emerg Care. 2007 Oct-Dec;11(4):416-20
17907026
J Allied Health. 2009 Fall;38(3):e84-91
19753419
Acad Emerg Med. 2008 Oct;15(10):923-31
18785942
J Clin Epidemiol. 1997 Oct;50(10):1129-36
9368521
Behav Sleep Med. 2008;6(1):1-15
18412034
Prehosp Emerg Care. 2009 Jul-Sep;13(3):388-97
19499479
J Crit Care. 2008 Jun;23(2):207-21
18538214
Appl Ergon. 2008 Sep;39(5):605-13
18395183
Prehosp Emerg Care. 2005 Oct-Dec;9(4):405-11
16263673
J Nurs Scholarsh. 2009;41(2):184-92
19538703
Ann Emerg Med. 2001 Jan;37(1):32-7
11145768
Geriatr Nurs. 2007 Mar-Apr;28(2):126-36
17430747
J Public Health Manag Pract. 2009 May-Jun;15(3):246-52
19363405
Prehosp Disaster Med. 1999 Oct-Dec;14(4):240-4
10915410
Am J Med Qual. 2010 Mar-Apr;25(2):109-15
20133519
Ann Emerg Med. 2008 Sep;52(3):256-62
18407375
J Am Coll Surg. 2006 May;202(5):746-52
16648014
J Allied Health. 2005 Fall;34(3):153-62
16252678