Violence against paramedics: Protocol for evaluating one year of reports from a novel, point-of-event reporting process

BackgroundViolence against paramedics has been described as a “serious public health problem” with the potential for significant physical and psychological harm, but the organizational culture within the profession encourages paramedics to consider violence as just ‘part of the job’. The result is that most incidents of violence are never formally documented. This limits the ability of researchers and policymakers alike to develop strategies that mitigate the risk and enhance paramedic safety. ObjectivesFollowing the development and implementation of a novel, point-of-event violence reporting process in February 2021, our objectives are to: (1)Estimate the prevalence of violence and generate a descriptive profile for incidents of reported violence (2)Identify potentially high-risk service calls based on characteristics of calls that are generally known to the responding paramedics at the point of dispatch (3)Explore underpinning themes, including intolerance based on gender, race, and sexual orientation, that contribute to incidents of violence; and finally (4)Explore the potential contribution of frequent callers on the risk of violenceMethodsOur work is situated in a single paramedic service in Ontario, Canada. Using a convergent parallel mixed methods approach, we will retrospectively review one year of quantitative and qualitative data gathered from the External Violence Incident Reporting (EVIR) system. The EVIR is point-of-event reporting mechanism embedded in the electronic Patient Care Record (ePCR) developed through an extensive stakeholder engagement process. When completing an ePCR, paramedics are prompted to file an EVIR if they experienced violence on the call. Our methods include using descriptive statistics to estimate the prevalence of violence and describe the characteristics of reported incidents (Objective 1); logistic regression modelling to identify high-risk service calls (Objective 2) and the potential contribution of frequent callers on the risk of violence (Objective 4); and finally, qualitative content analysis of incident report narratives to identify underpinning themes that contribute to violence (Objective 3). ResultsWe anticipate being able to provide much needed epidemiological data on the prevalence of violence against paramedics in a single paramedic service, its contributing themes, and potential risk factors. ConclusionsOur findings will contribute to a growing body of literature demonstrating that violence against paramedics is a complex problem whose solutions require a nuanced understanding of its scope, risk factors, and contributing circumstances. Collectively, our research will inform larger, multi-site prospective studies already in the planning stage and inform organizational strategies to mitigate the risk of harm from violence.