Culture of Safety Strategy To-Do Lists: Groups

How associations, standards-setting bodies, government and media can get started on safety today


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...


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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;

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