title: Variation in emergency medical services workplace safety culture.
abstract: 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.
authors.affiliation: 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
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Patterson
authors.forename: David T
authors.initials: DT
authors.lastname: Huang
authors.forename: Rollin J
authors.initials: RJ
authors.lastname: Fairbanks
authors.forename: Scott
authors.initials: S
authors.lastname: Simeone
authors.forename: Matthew
authors.initials: M
authors.lastname: Weaver
authors.forename: Henry E
authors.initials: HE
authors.lastname: Wang
mesh_terms: 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
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