EMS & high reliability organizing. Achieving safety & reliability in the dynamic, high-risk environment

Area of Science:

• Organizational Psychology
• Emergency Medical Services (EMS) Research
• Human Factors Engineering

Background:

• Enactment involves engaging with situations to understand them, but also inherently changes them.
• Failure to act, often perceived as personal limitation, can inhibit future engagement and learning.
• Systemic issues within Emergency Medical Services (EMS) can lead providers to hesitate, reinforcing feelings of inadequacy.

Purpose of the Study:

• To explore the relationship between action, uncertainty, and learning in high-stakes environments.
• To analyze how systemic factors in EMS influence provider decision-making and performance.
• To introduce the principles of High-Reliability Organizations (HROs) as a framework for improving EMS performance.

Main Methods:

• Conceptual analysis of enactment, sensemaking, and performance in uncertain environments.
• Examination of how organizational systems in EMS can foster or inhibit action.
• Application of High-Reliability Organization (HRO) principles to EMS contexts.

Main Results:

• Hesitation to act in EMS, driven by systemic fears, prevents learning and reinforces perceived limitations.
• Effective sensemaking and learning occur through interaction and action, not avoidance.
• Historical approaches emphasize learning through doing, a principle often undermined by modern EMS systems.

Conclusions:

• EMS providers should embrace action in uncertainty, recognizing it as a learning opportunity, not a measure of limitation.
• Adapting High-Reliability Organization (HRO) principles can enhance individual and organizational performance in EMS.
• Systemic improvements are needed to encourage proactive engagement and continuous learning among EMS personnel.