Applying temporal framework of team processes to emergency medical services (EMS): perceptions of EMS providers
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Effective teamwork has been shown to optimize patient safety. However, teamwork research in Emergency Medical Services (EMS) is sparse. Before successful interventions can be implemented, the appropriate content of such interventions should be determined. We tested the applicability of a teamwork processes framework in emergency care (Fernandez et al., 2008) to the EMS context. We recruited participants from an EMS agency in Houston, TX, using purposive sampling. Full-time employees with a valid EMT/paramedic license were eligible. Using semi-structured format, we queried respondents on task/team functions and enablers/obstacles of teamwork in EMS. Phone interviews were recorded and transcribed. Structural coding was based on our theoretical model. Through a deliberative process, we combined codes into candidate themes. Analytic memos during coding and analysis identified potential themes, which were reviewed/refined, and compared against our framework. We reached saturation once 32 respondents completed interviews. Among participants, 30 (94%) were male; the median experience was 15 years. Our analysis identified the team processes in the Marks’ Teamwork Process Model in four domains: Action, Planning, Reflection and Interpersonal Processes. Additionally, the concepts cited as being central to team effectiveness in EMS were: leadership, crew familiarity, team cohesion, interpersonal trust, shared mental models, and procedural knowledge. The revised model was useful for describing teamwork processes that providers employ to drive performance in EMS. Additionally, we identified emergent concepts that influence teamwork processes in EMS. Our findings inform our understanding of teamwork processes in EMS, and may be useful in guiding future team-based interventions tailored to EMS.