Third Draft of National EMS Culture of Safety Strategy Released

The on-the-job injury and fatality numbers are enough to tell you EMS is a risky profession. But safety’s about more than just wearing gloves and clearing intersections. It’s an encompassing perspective and creed that informs our medicine, operations and personal lives. Beyond us, it affects our patients and the public too.

That’s plenty of reason to foster good safety practices in EMS, and the reason behind the EMS Culture of Safety project, a three-year effort led by NHTSA and the American College of Emergency Physicians (ACEP) and involving representatives from the major national EMS and fire organizations. Together they’re working to develop a strategy to guide our industry toward that elusive comprehensive culture of safety.

On May 16 the project team released the third draft of its road map to getting there, the Strategy for a National EMS Culture of Safety, which incorporates the contents of its various meetings and reviews, two prior drafts and an initial public comment period.

Another public comment period now commences, culminating in a review meeting in Washington, DC, on June 19. A fourth and final version of the strategy will ultimately follow that.

New to the third draft is a section on special safety concerns for providers, patients and the public and a revamped section on the elements envisioned to comprise the EMS culture of safety. The new version proposes six key elements to that:

• Just culture, which is “an organizational environment that encourages individuals to report mistakes so that the precursors to errors can be better understood in order to fix system issues.” Just culture is a feature of the aviation industry and other areas of healthcare.

• Coordinated support and resources through a dedicated center that will coordinate safety information among stakeholders and help disseminate best practices.

• A national EMS responder and patient safety data system by which the scope, nature and frequency of injuries and adverse medical events can be tracked.

• Safety education initiatives in initial training and CE.

• Standards in areas like physical fitness, shifts/fatigue, reporting violence against responders, driver performance, ambulance design, PPE use and more.

• Requirements for reporting of standardized data and investigation of unsafe events.

The strategy also provides numerous “next steps” for all industry players, including individual providers, agencies, medical directors, associations, educators, vendors and others.

For more, see