Does Quality of Teamwork Mediate the Relationship Between Partner Familiarity and EMT Injuries?

Details

• Personal Author:
  Hostler D ; Krackhardt D ; Landsittel D ; Patterson PD ; Salas E ; Yealy DM
• Description:
  BACKGROUND: Teamwork is vitally important in high-risk occupations such as Emergency Medical Services (EMS). Previous research links lack of familiarity between teammates to poor performance and negative safety outcomes. Most EMS workers are deployed in crews of two and work extended shifts of 12 or 24 hours. Prior research with small study samples suggest greater than two-thirds of EMS teams are unfamiliar and at risk of a workplace injury due to lack of familiarity. There is reason to believe that positive teamwork behaviors (e.g., frequent communication) may mediate the relationship between teammate familiarity and injury. METHODS: From January 2011 to November 2013 we abstracted a mean of 29-months of shift records and Occupational Safety Health Administration injury logs from 14 EMS organizations with 37 total bases located in four U.S. Census regions. Total teammate familiarity was calculated for each dyad as the total number of times a dyad worked together over the study period. We used negative binomial regression to examine differences in injury incidence rate ratios (IRR) by familiarity. We then randomly selected and surveyed 1,000 EMS workers to determine perceptions of teamwork with recent teammates. We tested a hypothesized role of teamwork as a mediator in the relationship between familiarity and injury. RESULTS: We analyzed 715,826 shift records, representing 4,197 EMS clinicians and 60,701 unique dyads. We determined the mean shifts per dyad was (5.9, SD 19.7), and quartiles of familiarity were 1 shift worked together over the study period, 2-3 shifts, 4-9 shifts, and >/=10 shifts worked together. More than half of all dyads worked one shift together (53.9%, n=32,739), 24.8% of dyads 2-3 shifts, 11.8% worked 4-9 shifts, and 9.6% worked >/=10 shifts. The overall incidence rate of injury across all organizations was 17.5 per 100 FTE, range 4.7 to 85.6 per 100 FTE. The raw injury rate was 33.5 per 100 FTEs for dyads with one shift of total familiarity, 14.2 for 2-3 shifts, 8.3 for 4-9 shifts, and 0.3 for >/=10 shifts. Negative binomial regression confirmed that dyads with>/=10 shifts had the lowest incidence of injury (IRR=0.03; 95%CI 0.02-0.04). We received 2,566 surveys from 333 out of 1,000 sampled EMS workers. Our hypothesis that increased teammate familiarity protects against adverse safety outcomes through development of positive teamwork behaviors was not supported. CONCLUSIONS: We provide benchmarking / base-rate data for teammate familiarity in dyadic EMS teams. Familiarity between teammates varies in the EMS setting, and less familiarity is associated with greater incidence of workplace injury. In select samples of EMS workers with a high degree of teammate familiarity, higher levels of 'back-up assistance' to teammates can increase the likelihood of injury. Findings may impact policies that guide formation of new work teams. The dangers of providing too much 'back-up assistance' to teammates and neglecting one's own tasks in high-risk settings should be emphasized during training and education. [Description provided by NIOSH]
• Subjects:
  Behavior Emergency Responders Morbidity Mortality Occupational Health Safety Workplace
• Keywords:
  Behavior Patterns Emergency Medical Services Workers Emergency Responders EMS Injuries Morbidity Rates Mortality Rates Safety Practices Work Environment
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-9
• NIOSHTIC Number:
  nn:20053814
• NTIS Accession Number:
  PB2019-100390
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R21-OH-010025, 2015 Dec; :1-9
• Contact Point Address:
  P. Daniel Patterson, PhD, Senior Scientist, Department of Emergency Medicine, Carolinas Medical Center, Director of Research for MedCenter Air, 1000 Blythe Blvd, MEB Bldg., MEB 304J, Charlotte, NC 28203
• Email:
  daniel.patterson@carolinas.org
• Federal Fiscal Year:
  2016
• NORA Priority Area:
  Public Safety
• Performing Organization:
  University of Pittsburgh, Pittsburgh
• Peer Reviewed:
  False
• Start Date:
  20120701
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20150630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4d63d227a3eafb99202403dbd7486a9858fbde6121f9fe210d84b5e9f3410f03ee7aed4ad6a426b5b8c70507a0e7f57596bca68cec5d8449c3b335683e5bf542
• Download URL:
  https://stacks.cdc.gov/view/cdc/218782/cdc_218782_DS1.pdf
• File Type:
  [PDF - 122.31 KB ]