EMS Safety Attitudes Questionnaire (EMS-SAQ)
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
Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ)
While organizational culture may be characterized using independent observation, the use of structured survey instruments provides an efficient method for collecting data from large groups of individual workers. When groups of individual attitudes are collected and assessed as a whole, this measure reflects the workplace culture (or climate) of the unit.
In this study we will use a modified version of the Safety Attitudes Questionnaire, an instrument that has been broadly used to characterize healthcare safety culture. The Safety Attitudes Questionnaire (SAQ) was derived from the Flight Management Attitude Questionnaire (FMAQ), a human factors survey widely used to measure commercial aviation cockpit culture.7, 19-21 The SAQ is distinct from other medical attitudinal surveys in that it maintains continuity with the FMAQ, which has been used for over 20 years.6, 7, 21 This continuity allows for comparisons between professions as well as for the identification of common human factors issues. The SAQ has been adapted for use in intensive care units (ICU), operating rooms (OR), general inpatient settings (Medical Ward, Surgical Ward, etc.), and Ambulatory Clinics.
The SAQ elicits caregiver attitudes regarding six domains:5
| Domain | Example Items from ICU SAQ |
| 1) Safety climate: perceptions of a strong and proactive organizational commitment to safety | - I would feel perfectly safe being treated in this ICU - ICU personnel frequently disregard rules or guidelines developed for our ICU |
| 2) Teamwork climate: perceived quality of collaboration between personnel | - Disagreements in the ICU are appropriately resolved (i.e., what is best for the patient) - Our doctors and nurses work together as a well coordinated team |
| 3) Stress recognition: acknowledgement of how performance is influenced by stressors | - I am less effective at work when fatigued - When my workload becomes excessive, my performance is impaired |
| 4) Perceptions of management: approval of managerial action | - Hospital management supports my daily efforts the ICU - Hospital management is doing a good job |
| 5) Working conditions:> perceived quality of the ICU work environment and logistical support (staffing, equipment etc.) | - Our levels of staffing are sufficient to handle the number of patients - The ICU equipment in our hospital is adequate |
| 6) Job satisfaction: positivity about the work experience. | - I like my job - This hospital is a good place to work |
We are refining a pilot version of the EMS-SAQ that parallels the ICU version of the SAQ, eliminating questions that are irrelevant to EMS and modifying the language to conform to EMS terminology. We also added several questions related to EMS vehicular operation. We have pilot-tested the instrument at three ground-based EMS agencies in the Pittsburgh area. Among the 77 respondents, the mean scores for each domain ranged from 60.1 to 75.1, with standard deviations ranging from 18.9 to 22.9.
Study Links:
Click here to view a brief presentation about the EMS-SAQ Study
Click here to view an extended, detailed presentation on the EMS-SAQ Study
This presentation was designed as an extended overview, intended for research study site coordinators.
Sample Online Survey
References
