Evaluating safety culture changes over time with the emergency medical services safety attitudes questionnaire

Introduction The correlation between patient outcomes and the safety culture in healthcare organisations draws special attention to tools that can measure safety culture in such organisations. One of the advantages of such tools is their ability to identify changes in safety climate, which can support healthcare organisations in detecting and understanding trends, which might have otherwise been overlooked. Objective To evaluate the ability of a standard survey to capture long-term safety climate changes in pre-hospital care. Methods The previously validated Emergency Medical Services Safety Attitudes Questionnaire was administered in one regional base hospital program, which delegates to six pre-hospital emergency care services. The survey was administered over two consecutive years, thus allowing us to measure safety climate changes over time. Results Significant differences were found between the first and second years of the survey in specific services. Conclusion While we cannot identify the specific causes for the change in scores in the various services between the two survey years, we can draw some inferences. We suggest that the small changes that tend to reflect a consistent change across all services are the result of training and educational initiatives, while greater changes in some of the services reflect a change in the attitude of the paramedics to the service, driven by changes in operational procedures within the service. Our findings demonstrate that the questionnaire can capture safety climate changes over time in pre-hospital emergency care.