Emergency Medical Services Safety Attitudes Questionnaire Manual ...

Emergency Medical Services Safety Attitudes Questionnaire Manual of Operations DRAFT

EMS Safety Attitudes Questionnaire Manual of Operations October 26, 2007

QUICK-START GUIDE

1. Complete the EMS-SAQ EMS Agency Demographics Survey • Call or e-mail for help answering the questions • Pay special attention to question 25 – the personnel in the shaded part of the table are eligible and should complete the survey. • Pay special attention to questions 27 and 28. If you plan to use the internet survey system, provide a list of eligible personnel and their emails for question 28. (You may substitute any pre-existing list of personnel and their emails) • Email or US mail the completed survey to the Pittsburgh study coordinating center. 2. If you choose to use paper surveys: • We will send a package to you with printed surveys, envelopes and pencils. • Identify a session when a large portion of EMS personnel will gather. Set aside a 10-15 minute period free of other distractions to complete the survey. • Distribute the survey, introductory letter, and #2 pencil to eligible personnel. Only eligible personnel should complete the survey. • Try to track down personnel who have not completed the survey. nts. • Return surveys to Pittsburgh study coordinating center via US mail. 3. If you choose to use internet survey: • Provide a list of e-mails for eligible personnel. • Help the study team to troubleshoot failed or invalid e-mails. • Remind personnel to look out for this important email and to take a minute to complete the survey. 4. If you choose to use a combination of internet and paper surveys: • Contact us for specific instructions. QUICK-LIST OF KEY CONTACTS Daniel Patterson, PhD – [email protected] - 412-647-3183 Scott Simeone, BS, NREMT-P – [email protected] – 412-647-3078 Henry E. Wang, MD, MS – [email protected] - 412-647-4925 EMS-SAQ Study c/o Daniel Patterson, PhD Department of Emergency Medicine University of Pittsburgh 230 McKee Place, Suite 400 Pittsburgh, PA 15213

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EMS Safety Attitudes Questionnaire Manual of Operations October 26, 2007 Study Contacts

Investigators

Emilie Ying (Webmaster for CCTCORE/EMS-SAQ web page) Database Manager/Research Analyst Boston MedFlight [email protected] 781-863-2213x260

Henry E. Wang, MD, MPH – Principal Investigator Assistant Professor Department of Emergency Medicine University of Pittsburgh 230 McKee Place Suite 400 Pittsburgh, PA 15213 412-647-4925/412-303-7793 [email protected]

Key Survey© 2001-2007 WorldAPP (Company providing survey services) Sales contact: Matt Haney Account Manager: Victoriya Voronko 222 Forbes Road Braintree MA 02184 [email protected] 888-708-8118

P. Daniel Patterson, PhD Assistant Professor Department of Emergency Medicine University of Pittsburgh 230 McKee Place Suite 400 Pittsburgh, PA 15213 412-647-3183 [email protected]

Carol E. Baker (Pitt test scoring center) Measurement and Evaluation Technology University of Pittsburgh 412-624-6440 [email protected]

David T. Huang Assistant Professor Department of Critical Care Medicine University of Pittsburgh 412-647-3135 [email protected]

Pearson Print and Services (Scantron publisher) Marcia Eayer 3975 Continental Dr. Columbia, PA 17512 [email protected] 800-735-2566

Other Staff and Key Contacts Scott Simeone, BS, NREMT-P (Research Assistant) 412-647-3078 [email protected] Matthew Weaver, EMT-B (Research Assistant) 724-456-4176 [email protected] Maureen Morgan – Dr. Wang’s Assistant 412-647-3078 412-647-6999 (fax) [email protected]

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EMS Safety Attitudes Questionnaire Manual of Operations October 26, 2007 Advisory Board Rollin J. (Terry) Fairbanks, MD, MS Assistant Professor Associate Medical Director, Monroe and Livingston Counties EMS Region, New York University of Rochester Rochester, NY Michael Hubble, PhD Associate Professor Emergency Medical Care Program Director Western Carolina University Cullowhee, NC Russell MacDonald, MD, MPH, FCFP, FRCPC Medical Director, Research Program, Ornge Assistant Professor, Department of Medicine University of Toronto Toronto, Ontario, Canada Ronald Roth, MD Associate Professor Department of Emergency Medicine University of Pittsburgh Medical Director City of Pittsburgh, Bureau of EMS Pittsburgh, PA Steven Thomas, MD, MPH Associate Medical Director Boston MedFlight Assistant Professor, Department of Surgery Harvard Medical School Boston, MA Owen Traynor, MD Medical Director, Paramedic Education Center for Emergency Medicine Pittsburgh, PA Howard Werman, MD Medical Director, MedFlight of Ohio Professor of Clinical Emergency Medicine The Ohio State University Columbus, OH

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EMS Safety Attitudes Questionnaire Manual of Operations October 26, 2007 Purpose and Overview of the Study The purpose of this Study is to characterize Emergency Medical Services (EMS) workplace and safety culture using the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ). The study will involve the dissemination of the EMS-SAQ to EMS personnel at sixty ground and airmedical based EMS agencies across the United States. Demographic and systems characteristic information will be collected separately from each EMS agency. The analytic objectives are to characterize variation in workplace culture, as well as to draw associations will individual system characteristics. Funding This study is supported by grants from the Foundation for Air-Medical Research and Education (FARE) and the Pittsburgh Emergency Medicine Foundation (PEMF). Dr. Wang is supported by Clinical Scientist Development Award K08-HS013628 from the Agency for Health Care Research and Quality. Institutional Review Board Approval This study is approved by the Institutional Review Boards of the University of Pittsburgh as an “exempt” (no human subjects research) protocol (protocol # 0611048). Background The goal of this effort is to characterize EMS organizational safety culture. A growing body of literature highlights the growing problem with medical errors in Emergency Medical Services (EMS).1-4 Organizational culture refers to the beliefs, attitudes and values of its personnel.5 Extensive efforts in the aviation industry have demonstrated that workplace organizational culture may directly relate to the safety of operations.6-11 There is growing awareness that organizational culture may also have strong ties to patient safety and outcomes in healthcare settings.5, 12-18 Overview of the EMS-SAQ Survey and its Components The EMS-SAQ survey is a series of questions related to workplace culture and safety. The questions are centered around 6 domains (Appendix 1) regarding organizational culture; safety climate, teamwork climate, stress recognition, perceptions of management, working conditions and job satisfaction. Thirty of the questions are “core” questions directly adapted from other versions of the SAQ. The core questions are used to derive scores for each domain. The remaining items relate to other areas of EMS operations. Two formats of the EMS-SAQ will be available in this study. 1) Paper survey forms to be completed using a #2 pencil, 2) Internet web-based survey (Appendix 2). A pilot version of the EMS-SAQ was tested at three Pittsburgh area EMS agencies in early 2007. This preliminary effort verified the feasibility of administering the survey, the face validity of the survey, and the internal consistency of the core survey questions as administered to a population of EMS providers. Overview of Demographic Survey The purpose of the demographic survey is to provide basic information regarding each participating EMS agency (Appendix 3).

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EMS Safety Attitudes Questionnaire Manual of Operations October 26, 2007 Directions for Administering the EMS-SAQ Survey This section summarizes the steps for administering the EMS-SAQ survey at each EMS agency. −

Who should coordinate administration of the survey? Each participating EMS agency should designate a site coordinator to carry out the study procedures.

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Task 1. Complete the Demographic Survey Each site coordinator should complete the demographic survey. This may require identifying aggregate statistics using computer patient care records or other preexisting data. Fill in the Microsoft Word file or hand-write responses on a printed survey. Return the survey by mail or email to the Pittsburgh study coordinating center.

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Task 2. Determine the number of eligible personnel at each EMS agency. An essential goal of the EMS-SAQ study is to maximize the survey return rate. In other words, we want to make sure that as many eligible personnel complete the survey as possible. To determine the survey return rate, you must determine the number of eligible personnel at your EMS agency using a current roster. THE PROCESS OF IDENTIFYING ELIGIBLE PERSONNEL IS OUTLINED ON QUESTION 27 OF THE EMS AGENCY DEMOGRAPHICS SURVEY. In summary, the survey should be distributed only to the following personnel at your EMS agency: • • • • •

Age ≥18 years old. Provide EMS patient care (paramedic, nurse, EMT, first responder) Full-time paid personnel (use your agency’s definition of “full-time”). Regular part-time paid personnel (personnel who work, on average, ≥1 ambulance or aircraft shift per week). Regular volunteer personnel (volunteers who provide regular on-call or scramble duty).

Exclude the following personnel (Do not distribute the survey to the following persons, and do not count these individuals as eligible personnel): • • • •

Age