Culture of Safety Strategy To-Do Lists: Groups

Achieving a national culture of safety in EMS is a long process, notes Sabina Braithwaite, MD, chair of the Culture of Safety Strategy Project’s steering committee, but one that comes with intermediate wins. What that means is that stakeholders of all stripes can take positive steps today, even unilaterally, that contribute to a safer work environment.

The strategy document lists some of these. See below to learn what you can do within various EMS groups (e.g., provider agencies, associations, standard-setting bodies, local/state government, media) to enhance the safety cause and help develop our much-needed safety culture. For actions you can take as an individual (e.g., single provider, physician/medical director, educator, researcher, vendor), see this list.

EMS Provider Agencies

Establish a better understanding of safety culture in EMS nationwide by encouraging local EMS agencies to measure their safety culture using reliable and valid tools (e.g., the EMSSAQ). This may be accomplished individually by the agency or by taking part in a national effort (e.g., EMSARN.org);

While educators can do some of this type of screening, emphasize the importance of developing pre-employment screening and evaluation tools based on solid research (for example, potential workers with a history of speeding violations or crashes will be more at risk than others for speeding or crashing the ambulance, and potential workers with previous back injuries will be more at risk for future back injuries). Such tools would not necessarily need to prohibit employment but could be used to track new employees into specialized mini-courses. However, screening such as this is not the purview of educators. Instead, employers must recognize their responsibility in articulating standards so that potential employees will know if they might be excluded from employment before undertaking a long educational program;

Adopt values of Just Culture or choose another model to review and adopt;

Find, develop or provide education and safety information (such as NAEMT’s EMS Safety Course) to membership;

Support or participate in research.

Associations

Adopt values of Just Culture or choose another model to review and adopt;

Find, develop or provide education and safety information to membership;

Support research; fund it, share results, issue press releases, publish on it, list research as a top priority of the organization;

Make safety part of the association’s mission;

Support the (yet to be developed) resource center. Share costs, share documents, etc.;

Raise the profile of safety wherever possible throughout the organization’s initiatives;

Include safety presentations at annual meetings and conferences;

Issue a proclamation supporting the Strategy or the concept of a culture of safety;

Partner with non-endemic organizations to bring outside safety ideas into the mix;

Make sure members have access to the Strategy document and are aware of it;

Find best practices, encourage members to share their safety policies and safety training materials;

Survey membership about safety practices and share the results;

Advocate for dedicated funding for research and mechanisms to distribute that funding for EMS safety research (both patient safety and provider/practitioner safety);

Consider an annual award for best practices in EMS safety.

Standard-Setting Bodies (e.g., NFPA, ASTM, CAAS)

Review accreditation to look for opportunities to include safety;

Consider standards related to wellness, annual fitness test;

Review research presented by TRB;

Evaluate benefits of mandating formal EMD training and procedures in dispatch centers.

Local Government Stakeholders

When putting ambulance services out to bid, incorporate safety as a high-profile consideration in RFPs, to include reporting/monitoring;

Ensure contractor adheres to a responsible UHU to reduce the likelihood of fatigue and other risks that may lead to injury or error;

Require that PSAPs have EMD;

Regional EMS councils should require continuing education, make changes to protocols to communication standards, make accreditation and licensure requirements, adopt the practices of Just Culture.

State Government Stakeholders

Introduce or strengthen legislation making it a felony to assault EMS responders;

Support research through the adoption of NEMSIS-compliant patient care reporting systems, state EMS vehicle-involved collision reporting, and promotion of voluntary anonymous reporting (e.g., through EVENT);

Modify state EMS laws or rules to incorporate safety-related provisions into local EMS agency and personnel requirements;

Include safety-related messages in all correspondence and documents sent to local EMS agency officials and personnel;

Adopt values of Just Culture or choose another model to review and adopt in the state EMS office;

Find, develop or provide education and safety information to EMS personnel and local EMS agency officials;

Make safety part of the state EMS office mission;

Support and utilize EMSSRC;

Raise profile of safety wherever possible throughout the organization’s initiatives;

Include safety presentations at annual meetings and conferences;

Issue a proclamation supporting the Strategy or the concept of a culture of safety;

Partner with non-endemic statewide or local organizations to bring outside safety ideas into the mix;

Find best practices, encourage EMS personnel and local EMS agency officials to share their safety policies and safety training materials;

Survey EMS personnel and local EMS agency officials about safety practices and share the results;

Ensure that EMS personnel and local EMS agency officials have access to the Strategy document and are aware of it.

EMS Media & Conferences

Conduct surveys and polls and report on the results;

Look for opportunities to promote and elevate safety, single subject articles and workshops;

Speaker guidelines at EMS conferences can ask speakers to integrate concepts of safety into their presentations as appropriate to the topic;

Assign articles based on concepts and topics that come from the Culture of Safety document;

Change author guidelines to consider safety issues in any topic;

Keep safety a hot topic in the community by covering it regularly and in a variety of ways.

Misc. or EMSSRC

Sponsor an interdisciplinary national conference on safety.