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The purpose of this paper is to examine emergency medical service (EMS) personnel’s perceptions and experiences of managing underground mining injury incidents.

In total, 13 EMS personnel were interviewed according to a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using qualitative content analysis.

An underground mining environment was described as unfamiliar and unsafe and, with no guidelines for operational actions in an extreme environment, such as underground mines, the EMS personnel were uncertain of their role. They therefore became passive and relied on the rescue service and mining company during a major incident. However, the medical care was not considered to be different from any other prehospital care, although a mining environment would make the situation more difficult and it would take longer for the mine workers to be placed under definitive care.

This study complements earlier studies by examining the EMS personnel’s perceptions and experiences of major incidents.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

This study explored the experiences of Irish emergency medical services (EMS) first responders during the first nationwide restrictions to curb the spread of COVID-19.

A systematic literature review (SLR) of research into healthcare workers' and first responders' experiences during the COVID-19 and 2003 SARS pandemics was performed. The SLR informed the content of an online questionnaire distributed via the Irish Pre-Hospital Emergency Care Council to 2,092 first responders on its live register. Data analysis used both descriptive and content analysis.

EMS first responders faced many challenges including PPE quality, training on its use, issues with decontamination facilities, and organisational effectiveness. Emotional challenges included the anxiety experienced, the impact on families, and ethical dilemmas confronted related to patient care. Positive findings also emerged, such as first responders' dedication to working through the pandemic, collegiality, and the community goodwill displayed.

While investigations of the impact of the COVID-19 pandemic on healthcare workers have been undertaken globally, studies focussing exclusively on the experiences of EMS first responders have been rare. This study addressed this knowledge gap, providing an insight into the challenges and successes experienced by first responders and identifying opportunities for learning that can be applied to future public health emergencies.

Public safety personnel (law enforcement, firefighters, emergency medical services and dispatchers) face work environments which are high stress. These can lead to burnout, secondary traumatic stress and a reduction of compassion satisfaction. However, very little is known about what individual and work factors influence these negative coping mechanisms in public safety personnel. It is also unknown how perceived organizational and coworker support, debriefing methods, or individual characteristics are associated with the aforementioned coping mechanisms. The differences between these fields are also unknown. The paper aims to discuss these issues.

A cross-sectional administration of surveys to Florida public safety personnel was done. A total of 1,360 public safety individuals completed the survey. Three regression analyses were carried out, utilizing the three Professional Quality of Life Version 5 subscales as the dependent variables. The Perceived Coworker Support Survey, Survey of Perceived Organizational Support, the Brief Resilience Survey and questions regarding debriefing practices were included.

Public safety personnel cannot be treated as a singular population for many things. An exception of this was that perceived organizational support and psychological resilience were associated with positive outcomes, albeit, to varying degrees in all fields. The other individual and organizational factors had very distinct impacts on the varying fields.

There are limitations due to the nature of cross-sectional survey design and due to the sample size.

This study displays statistical relationships between factors which public safety agencies could use to increase employee job satisfaction and potentially reduce turnover. It was the only study the authors could find which include dispatchers when comparing these four public safety fields.

The purpose of this article was to identify factors impacting burnout, resilience and quality of life in rural career firefighters. In addition, sources of stress and the impact of generational differences were explored.

An exploratory cross-sectional survey was conducted at a rural career fire department.

The findings of the project indicate that the firefighters had high levels of compassion satisfaction (CS) and relatively low levels of secondary traumatic stress and burnout; displayed moderate to high psychological resilience and the majority felt moderate to high organizational support, but there was a noticeable minority who did not feel supported by the department. Findings indicate that organizational support is significantly related to both burnout and resilience. The majority of the men (88.3%) reported moderate to high risk for alcohol-related problems and over three-quarters (78.6%) reported binge drinking behavior in the past year. Qualitative findings highlight generational differences and chain of command challenges as primary stressors.

This is a unique study in that it focuses on a rural career department. What was found were issues similar to those facing urban career fire departments.

The Open for Antiracism program supports faculty to change their teaching practices to be antiracist through the affordances of open educational resources (OER) and open pedagogy. This study aims to raise questions about how professional development impacts student outcomes, and how faculty perceive the utility of OER and open pedagogy to support antiracist teaching and learning.

An evaluation plan examined how faculty participants perceived the effectiveness of OER and open pedagogy to make their classes antiracist. Students compared their experiences in treated classes with those in other classes. Participating faculty completed pre- and post-surveys and a subset sat for interviews.

Faculty participants felt prepared to implement antiracist practices using OER and open pedagogy. Eighty-seven percent reported they were highly likely to recommend the program and 80% plan to continue using open pedagogy. Eighty percent of students reported they were more active or engaged than in other classes and that they examined biases of the discipline.

This study raises the question of how antiracist teaching approaches impact student outcomes over a longer term. Further, how can changes to teaching strategies impact institutions? Do teams of instructors offer support in ways that lead to a greater voice within an institution?

This paper proposes a method for managing client requirements with the use of Building Information Modelling (BIM). The development of healthcare projects demands a large amount of requirements information, in order to deal with a diversity of clients and frequents changes in healthcare services. The proposed method supports healthcare design by adopting a process-based approach for client requirements management, with the aim of improving value generation.

Design Science Research was the methodological approach adopted in this investigation. The main outcome of this study emerged from an empirical study carried out in a healthcare project in Brazil.

The proposed method involves three stages: (1) capturing and processing requirements; (2) product and requirements modelling, which involves the connection between requirements and the BIM 3-D model and (3) supporting design solution refinement, through the communication of requirements and the assessment of design in relation to updated client requirements information.

This study explores client requirements management from a process perspective, proposing activities and their interdependences and possible sources of data, including healthcare services information. The main theoretical contributions are related to the understanding of the nature and complexity of the information involved in client requirements management, and how this can be modelled.

The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients’ and medical staff’s perspectives.

A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.

A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.

There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients’ consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.

The purpose of this study is to analyse the crisis network response of European countries and the role played by defence organizations (DOs) during the early response phase of the pandemic, here set to encompass 75 days.

Published materials – reports, news and communications – provided by authorities and DOs were used. Some of the authors actively participated in national pandemic response networks. An exploratory approach and qualitative content analysis were applied. The data were collected in national languages from 13 European countries, and they were coded and analysed using the actors, resources and activities (ARA) framework.

This study identified three main categories of activity structures in which the DOs interacted with civilian members of response networks, health-related services, logistics services and public support services. These networks among actors were found within formal response systems and emergent networks. The DOs engaged as actors that provided a range of services when civil authorities could not cope with the huge demand for specific services and when resources were scarce in the initial response phase.

This study contributes by filling an important research gap with regard to the civil-military relations associated with the use of DO resources in the civil response to the pandemic crisis in Europe, which is described as an untraditional response. The ARA network approach provides a framework for arranging ARA and extends the wider civil-military network to expand the formal networks of the early crisis response. The study lays knowledge about the co-operation between civilian and military actors in different contexts and provides a broader understanding of the roles that DOs played in the response operations.

The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.

Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.

The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.

A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.

Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.