Association between EMS teammate familiarity and injury

Details

• Personal Author:
  Hostler D ; Krackhardt D ; Landsittel DP ; Patterson PD ; Salas E ; Vena J ; Weaver MD
• Description:
  Background: Care delivery in Emergency Medical Services (EMS) is high-risk, time-dependent, and requires coordination between two EMS clinicians (a dyad). Previous research suggests lack of familiarity between teammates is associated with increased risk of poor performance and safety outcomes.We sought to characterize EMS clinician dyadic familiarity and determine its association with injury. Findings may guide safety management and team configuration in EMS. Methods: We abstracted a mean of 26.3 months of shift records (range 22-35 months) and Occupational Safety Health Administration 300 injury logs from 37 EMS agencies and base sites spread across all 4 major census regions. EMS dyadic familiarity was calculated for each shift as the number of shifts worked together since the beginning of the study period. Plots and histograms guided stratification of familiarity exposure. We calculated standard measures of central tendency to describe our data. We calculated the annual incidence rate of injury (per 100 FTEs) for each category of dyadic familiarity. Poisson regression was used to examine differences in injury incidence rate ratios (IRR) by dyadic familiarity. Results: Total shift records collected was 728,182, total employees 4,241, total unique dyads 61,625, and total injuries 820. Mean shifts per dyad (5.9, SD 19.7). Shifts per dyad was skewed with 1 shift worked together at 53.7%, 2-3 shifts (24.8%), 4-9 shifts (11.8%), and >10 shifts (9.6%). Mean incidence rate of injury across EMS agencies was 13.7 per 100 FTEs, (SD 23.1), range 0.0 to 98 per 100 FTEs. The raw injury rate for 1 shift of familiarity 12.9, for 2-3 shifts 18.6, for 4-9 shifts 24.5, and for > = 10 shifts 16.5 per 100 FTEs. Compared to 1 shift of familiarity, dyads with 4-9 shifts had a higher incidence rate of injury (IRR = 1.9; 95%CI 1.2, 3.0) than dyads with 2-3 shifts (IRR = 1.4; 95%CI 0.9, 2.4) or > = 10 shifts (1.3, 95%CI 0.9, 1.9) (p<0.05). Conclusions: Findings show a curvilinear relationship between dyadic familiarity and injury. A possible yet untested explanation may be greater vigilance concerning risk of personal injury in unfamiliar versus familiar EMS teams. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Emergency Responders Health Personnel Occupational Health Safety Safety Management Shift Work Schedule Workplace
• Keywords:
  Emergency-care Emergency-treatment Exposure-levels Health-care-personnel Injuries Medical-care Medical-treatment Paramedical-services Performance-capability Safety-measures Safety-practices Shift-work Shift-workers Statistical-analysis Work-environment Workers

  More +
• ISSN:
  1090-3127
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  19
• Issue:
  1
• NIOSHTIC Number:
  nn:20047347
• Citation:
  Prehosp Emerg Care 2015 Jan; 19(1):151
• Federal Fiscal Year:
  2015
• NORA Priority Area:
  Public Safety
• Performing Organization:
  University of Pittsburgh, Pittsburgh
• Peer Reviewed:
  False
• Start Date:
  20120701
• Source Full Name:
  Prehospital Emergency Care
• End Date:
  20150630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d8e86b5c97df20d5061857d55e2c8d058a1a62bf267d110a464c3f313245ac6d16704f365b544d5d4ece99c5939596e2722ae107b4323241e9fd68d47f8fe0c7
• Download URL:
  https://stacks.cdc.gov/view/cdc/202452/cdc_202452_DS1.pdf
• File Type:
  [PDF - 315.48 KB ]