EMS NCCP Culture of Safety

1. EMS Culture
of Safety

2. Culture of Safety
• Definition - “The enduring value and priority
placed on worker and public safety by everyone
in every group at every level of an organization.
It refers to the extent to which individuals and
groups will commit to personal responsibility for
safety; act to preserve, enhance and communicate
safety concerns; strive to actively learn, adapt
and modify (both individual and organizational)
behavior based on lessons learned from mistakes;
and be rewarded in a manner consistent with
these values.”

3. Who is at risk?
• Risk of harm to EMS personnel
• Work under difficult, unpredictable, and rapidly
changing environments
• Work long hours, often in harsh conditions, with limited
info and assistance
• Exposed to illness, infectious diseases, emotional stress,
fatigue, and injury
• May encounter physical violence and personal liability
• More than 2.5 times likelier to be killed on the job
• Transportation injury rate 5 times higher than average

4. Who is at Risk?
• Risk of harm to patients
• Preventable adverse medical
events
• Safeguards often not in
place
• Negligent or incompetent
providers

5. Who is at risk?
•Risk of harm to members of
the community
•Transportation incidents

6. Six Core elements – EMS Culture of Safety
1. Just Culture
• Categorizes incidents
• Human Error – Provider should have done something different, or the
action inadvertently caused an undesirable outcome.
• Negligent Conduct – Provider performed below the reasonable skill
standard
• Reckless Conduct – Provider consciously performed an unjustified action
despite the likelihood of harm
• Intentional/Willful Violation – Provider knew the negative result and did it
anyway
• Focused on preventing future errors
• Distinguishes behavior separate from outcome
• Console human error
• Coach at-risk behavior (negligent conduct)
• Punish reckless behavior (reckless or intentional conduct)

7. Six Core elements – EMS Culture of Safety
2. Coordinated Support and Resources
• Unified message
• Visibility to support culture
• Collaboration
• Research sharing
3. National Data System
• Linkage – Data consolidated on a national
level
• Unified taxonomy
• Anonymous reporting

8. Six Core elements – EMS Culture of Safety
4. EMS Education Initiatives
• Educate EMS leadership – Safety starts with leadership
• Initial training programs should emphasize a culture of safety
• Continuing education and new employee onboarding should
support and build a culture of safety
• Build sound clinical judgment
5. EMS Safety Standards
• Develop and implement patient and responder safety standards
based on data and evidence
6. Requirements for Reporting and Investigation

9. Six Core elements – EMS Culture of Safety

10. Questions you need to consider regarding the policies, practices,
and daily operations in your organization/agency:
1. What are changes that is needed to encourage the
development of a culture of safety?
2. How mistakes are handled if one is made during the patient
care encounter?
3. How could it be handled if applying the concept of Just
Culture?