Senior ambulance officers in Swedish emergency medical services: a qualitative study of perceptions and experiences of a new management role in challenging incidents

Abstract

ObjectivesIncreased demands are placed on emergency services and their role and ability to act in incidents in challenging environments, for example, road tunnels. Collaboration between officers from emergency services (fire brigade, police and ambulance services) is important for an effective rescue effort. In Gothenburg, Sweden, a position as a senior ambulance officer (SAO) within the emergency medical services (EMS) has been introduced to support the regular force during major incidents. The aim of this paper was to explore the perceptions and experiences of the SAO’s new management role in challenging incidents, such as those occurring in road tunnels.DesignA qualitative interview study.SettingThe study was carried out from February to June 2019 in Gothenburg, Sweden, which is a municipality with several road tunnels and a population of approximately 580 000 people. SAOs collaborate with the corresponding function within the police and fire brigade, both having senior officers at major incident sites.ParticipantsTwelve SAOs.MethodsThe study used semistructured interviews. The collected data were analysed using qualitative content analysis.ResultsAccording to SAOs’ experience, prehospital medical management included not only leadership, but also planning, training and indepth knowledge of, for example, tunnel environments. Furthermore, SAOs adopted an encouraging and teaching role for their colleagues. SAOs’ responsibilities also included proactive planning together with the fire brigade and police, which was regarded as enhancing interorganisational collaboration. An overall theme emerged which the SAOs described as ‘A new holistic approach to EMS leadership and management’.ConclusionsThe participants considered that the new SAO role not only seems to improve the prehospital medical management, but also makes the EMS command structure during challenging incidents symmetrical with the fire brigade and police command structure. The implementation of national guidelines is desirable and is requested by the SAOs.

Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study

“…They all operate on different RFAs, having to relate to different boundaries stated by their own organizations, professional regulations, and applicable laws. Previous research on collaboration in the EMS in general, has often focused on time-sensitive emergencies, 36 or work with hospitals 37 but has paid less attention to low-priority missions. This study indicates that clinicians and ORs believe that EMS positioning in relation to possible collaborators needs strengthening to enable clinicians to act based on their CR.…”

Time-efficiency factors in road tunnel rescue as perceived by Swedish operative personnel – an interview study

“…In Norway, which has more than a thousand road tunnels, emergency services have developed specific tunnel-incident rescue strategies (Hylander et al, 2019). Hylander et al (2019Hylander et al ( , 2020 found that the most critical factor in their success was collaboration, beginning with on-scene commanders' decision-making, tactical support and prehospital care. Other studies have confirmed the importance of collaboration among various organisations, such as RS, police, emergency dispatch centres (EDCs) and infrastructure owners (Alvear et al, 2013;Bj€ ornstig and N€ asman, 2017;Nj a and Svela, 2018).…”

“…Hylander et al. (2019, 2020) found that the most critical factor in their success was collaboration, beginning with on-scene commanders' decision-making, tactical support and prehospital care. Other studies have confirmed the importance of collaboration among various organisations, such as RS, police, emergency dispatch centres (EDCs) and infrastructure owners (Alvear et al.…”