The #1 topic they didn’t teach you in Paramedic School: Culture

November 26, 2018    |   By: Shelby Cox, NREMT-P

I have been working with the Center for Patient Safety (CPS) for about four months, and I’m learning something new every day.  As a Paramedic, patient safety has always been a high priority, but I didn’t know how an organization’s culture could impact the delivery of care.

Much of what we do at CPS is to educate, inform and help others make the connection between culture and safety.  While that might sound simple, it’s a rather complicated task.  Also, it’s about finding leaders and providers that are willing to listen and learn about these concepts that aren’t taught in Paramedic school.

Culture is comprised of many things including the collective beliefs, attitudes, perceptions, and values of the employees and the entire organization. How would you describe your organization’s culture? Did you know that you can measure it?

The EMS Safety Culture Assessment provided by CPS offers an organization the tools to understand their strengths and opportunities when it comes to their safety culture.  Many use it as a tool before implementation of just culture or as a baseline measurement of the values within their organization and then come back a year later and re-measure to see how their work has improved the safety culture.

The Safety Culture Assessment can also help with local or regional quality improvement projects and initiatives as it measures areas such as patient handoffs and communications between healthcare providers. These are just a few reasons why measuring your culture should be something that is not only accepted by EMS but expected in EMS just as it is in other healthcare settings.

Years ago I worked as a flight Paramedic and the safety culture in an air-based service seemed to be more advanced since it was linked to aviation. It was acceptable to turn down a flight and have a safe time-out due to severe exhaustion or if something didn’t seem right. As a ground paramedic, a safety time-out didn’t exist and many had never heard of it. Today, many years later, safety precautions like time-outs, are more common and practiced within a growing number of ground organizations.

One of the interesting things I get to do in my new position is listen to how leaders and providers describe their safety culture.  However, just like the safety time-out, many have never thought about it or can’t describe it.

One agency recently completed the EMS Safety Culture Assessment and learned of staff concerns regarding a change from 24-hour shifts to 48-hour shifts and how that change could impact patient and provider safety. As a result, the ground service implemented a time-out policy that addresses exhaustion, a pro-active approach to building a safe culture.

Do you have a safe organization where employees come to you with concerns about an unsafe situation or when a mistake occurs? Alternatively, are you the Chief that believes near misses and mistakes do not happen within your organization? How do you truly know the thoughts and feelings of the employees within your organization if you haven’t assessed the culture or given them the opportunity to speak up without the fear of repercussions from their colleagues and administration?

Our mission at the Center for Patient Safety is: Reducing preventable harm, but what does that mean and how do you accomplish that? The EMS Safety Culture Assessment is the first step in recognizing and learning about the culture component of your organization.

The EMS Safety Culture Assessment provided by CPS gives employees a voice that is trusted and de-identified so they can speak up without fear of retribution from colleagues or punishment from administration. The assessment also helps administration recognize the need to fulfill a safe practice and utilize the results to make positive changes within their organization.

Shouldn’t all first responders feel safe within the environment they call their second home?

Please contact me so we can start your EMS safety journey today! Your employees and your community are counting on you!

Shelby Cox


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