On this page, we list peer-reviewed publications resulting from, or leading to, the development of EMSARN projects.

All publications are listed by topic area.

Full-text provided for selected publications with permission from journal editor.

NOTE: We do not provide copies of the detailed reports or summary briefs supplied to EMS agencies in return for their participation in EMSARN projects. We are more than happy to share copies of templates to agencies interested in participation.


Safety Culture

1. Patterson PD, Huang DT, Fairbanks RJ, Wang HE. The emergency medical services safety attitudes questionnaire. Am J Med Qual. 2010; 25(2):109-115. PMID: 20133519

2. Patterson PD, Huang DT, Fairbanks RJ, Simeone S, Weaver MD, Wang HE. Variation in emergency medical services workplace safety culture. Prehosp Emerg Care. 2010; 14(4):448-460. PMID: 20809688. PMCID: 2935310.

3. Patterson PD, Wang HE, Fairbanks RJ, Weaver MD. Association between EMS Workplace Safety Culture and Safety Outcomes. Prehosp Emerg Care. 2011; 15(1):104-137 PMID: 21950463.


Sleep Quality and Fatigue

1. Patterson PD, Suffoletto BP, Kupas DF, Weaver MD, Hostler D. Sleep quality and fatigue among prehospital providers. Prehosp Emerg Care. 2010; 14(2):187-193. PMID 20199233. PMCID: 2895322.

2. Patterson PD, Weaver MD, Frank RC, Warner CW, Martin-Gill C, Guyette FX, Fairbanks RJ, Hubble MW, Songer TJ, Callaway CW, Kelsey SF, Hostler D. Association Between Poor Sleep, Fatigue, and Safety Outcomes in Emergency Medical Services Providers. Prehosp Emerg Care. 2011 Oct 24. [Epub ahead of print] PubMed PMID: 22023164.

3. Patterson PD, Weaver MD, Hostler D, Guyette FX, Callaway CW, Yealy DM. The Shift Length, Fatigue, and Safety Conundrum in EMS. Prehosp Emerg Care. Epub ahead of print 2012 July 23.

Turnover and Cost of Turnover in EMS

1. Patterson PD, Jones CB, Hubble MW, Carr M, Weaver MD, Engberg J, Castle N. The longitudinal study of turnover and the cost of turnover in emergency medical services. Prehosp Emerg Care. 2010; 14(2):209-221. PMID: 20199235. PMCID: 2883888.


Teamwork and Conflict in EMS

1. Patterson PD, Arnold RM, Abebe K, Lave JR, Krackhardt D, Carr M, Weaver MD, Yealy DM. Variation in Emergency Medical Technician Partner Familiarity. Health Serv Res. 2011 Aug;46(4):1319-1331. doi: 10.1111/j.1475-6773.2011.01241.x. Epub 2011 Feb 9.

2. Patterson PD, Weaver MD, Weaver S, Rosen M, Todorova G, Weingart L, Krackhardt D, Lave J, Arnold R, Yealy DM, Salas E. Measuring Teamwork and Conflict among Emergency Medical Technician Personnel. Prehosp Emerg Care. 2012; 16(1):98-108. PMID: 22128909. PMCID: PMC3233978. [Available on 2013/1/1]


Patient and Provider Safety Outcomes

1. Patterson PD, Lave JR, Martin-Gill C, Weaver MD, Wadas RJ, Arnold RM, Roth RN, Mosesso VN, Guyette FX, Rittenberger JC, Yealy DM. Measuring Adverse Events in Helicopter Emergency Medical Services: Establishing Content Validity. Prehosp Emerg Care. 2013 Sep 4. [Epub ahead of print] PubMed PMID: 24003951.

2. Patterson PD, Weaver MD, Abebe K, Martin-Gill C, Roth RN, Suyama J, Guyette FX, Rittenberger JC, Krackhardt D, Arnold R, Yealy DM, Lave J. Identification of Adverse Events in Ground Transport Emergency Medical Services. Am J Med Qual. 2011 Aug 4. PMID:21816967.

3. Patterson PD, Weaver MD, Martin-Gill C, Roth R, Guyette F, Rittenberger J, Suyama J, Suffoletto B, Fairbanks RJ, Hubble M, Hostler D, Wang HE. [Abstract #106] Results from the emergency medical services provider and patient safety inventory tool. Prehosp Emerg Care. 2011; 15(1):104-137. (pages 129-130).

*** Full text of this abstract published here with permission from Dr. James Menegazzi, Editor-in-Chief of Prehospital Emergency Care ***

Background. Measurement of safety-related events is an important step to ensuring a safe workplace.

Objective. We developed and administered a computer-based survey to capture emergency medical technician (EMT) injuries, errors and adverse events, and indicators and behaviors that compromise patient and provider safety.

Methods. We used input from medical directors, field providers, emergency medical services (EMS) educators, and survey researchers to develop a 44-item computer-based survey, the EMS Safety Inventory (EMS- SI). The EMS-SI was administered to a convenience sample of 1,488 EMTs and paramedics at 31 EMS agencies. The EMS providers (EMTs and paramedics) responded to items based on events at work from the prior three months. Respondents used nominal and seven-point Likert scales. For each item, we considered an event to have occurred when an EMT recorded a “probably yes” or “definitely yes” for one scale and/or “ran out of time,” “forgot to perform,” or “did not think necessary” for the second scale. We calculated frequencies and percentages for each item.

Results. We received 595 surveys (40% collection rate). Half of the respondents (55%) were paramedic certified and 71% worked full-time. In the previous three months, 51% of the respondents reported to work without adequate rest, 32% were at an unsafe scene, 17% were injured, and 5% were involved in a vehicle collision. Eleven percent knowingly recorded inaccurate information on a patient care report, 7% failed to check glucose in a patient with altered mental status, and 8% did not perform 12-lead electrocardiography (ECG) on a patient with chest pain. Fifteen percent reported feeling that their patients’ safety was jeopardized because their agency did not provide updated equipment. Forty-seven percent reported routinely exceeding the speed limit while driving the ambulance in a non-emergency mode. Forty percent reported greatly exceeding the speed limit (>15 mph) while responding with lights and sirens, and 50% reported chute times greater than 1 minute.

Conclusions. The EMS personnel voluntarily reported high rates of injury, errors, acts of commission and omission, and behaviors that may have compromised personal or patient safety. This inventory of safety items may serve as a useful tool for monitoring and benchmarking EMS workplace safety.

Book Chapters

  1. Patterson PD, Weaver MD, Hostler D. Occupational Injury Prevention and Management. Prehospital Systems and Medical Oversight. A publication of the National Association of EMS Physicians in concert with Wiley-Blackwell Publishers. Editors: Drs. Jane Brice, David Cone, Ted Delbridge, and Brent Myers. Expected date of publication – January 2015.

  2. Patterson PD, Weaver MD, Hostler D. EMS Provider Wellness. Prehospital Systems and Medical Oversight. A publication of the National Association of EMS Physicians in concert with Wiley-Blackwell Publishers. Editors: Drs. Jane Brice, David Cone, Ted Delbridge, and Brent Myers. Expected date of publication – January 2015.