"Solving for violence while leveraging our professional strenghts means developing strategies to proactively identify emergency calls with the potential for violence and implement response plans tailored to the degree of risk" 

The out-of-hospital context can indeed be challenging, but paramedics are are adept at adapting the environment to optimize patient care. We can do the same to reduce the risk of violence during 9-1-1 calls. 

Citation

Mausz, J. (2024). Where crisis meets care: Rethinking our approach to occupational violence in paramedicine. Paramedicine, early online. 

Bill C-321, if passed, will amend the Criminal Code of Canada to require judges to consider the fact that the victim of an assault (or a related offence) is a healthcare or public safety professional as an aggravating factor during sentencing. In short, this legislation would enable harsher sentences for people who perpetrate criminal violence against paramedics and other first responders or healthcare workers. 

Keep up-to-date on Bill C-321 here.

Citation

Mausz, J. (2024). Violence against healthcare and public safety professionals: Is bill C-321 a solution? Canadian Journal of Emergency Medicine, 26, 221-226.

Where a person has a history of violence, conveying this information to paramedics can potentially reduce the risk of harm to both the patient and the responding paramedics during subsequent 9-1-1- calls. We evaluated a hazard flagging program in Peel Region after more than a year of violence reports and found:

• More serious (i.e., assaults casing harm) were less likely to occur at locations that could be flagged under policy

• Calls at flagged addresses were associated with an increased risk of subsequent violence reports being filed

What this tells us is that - if refined - the concept could be a useful strategy to strengthen paramedic safety. Stay tuned.

Citation

Mausz, J., Piquette, D., Bradford, R., Johnston, M., Batt, A. M., & Donnelly, E. A. (2024). Hazard flagging as a risk mitigation strategy for violence against emergency medical services. Healthcare, 12, 509.

Violence doesn't have to be physical. In an analysis of more than five hundred violence reports, our team identified that nearly 1 in 4 documented some form of abuse targeting protected identity grounds:

• 18% involved sexist or misogynistic comments

• 9% involved racial slurs

• 2% involved homophobic language

Abuse on protected identity grounds was associated with a 60% increase in the risk of emotional distress among paramedics.

Citation

Mausz, J., D'Eath, J., Jackson, N. A., Johnston, M., Batt, A. M., & Donnelly, E. A. (2024). Sexist, racist, and homophobic violence against paramedics in a single Canadian site. International Journal of Environmental Research and Public Health, 21, 505.

Solving for violence means first solving for institutionalized underreporting. For decades, violence has been considered 'just part of the job', with all but the most serious incidents going unreported. Following 18 months since introducing a novel, point-of-event reporting process in Peel Region, we surveyed paramedics about their experiencs with the new reporting process and their willingness to report violence.  

We found:

• Willingness to report more than doubled since introducing the new system

• 85% of participants said their experience with the new process encouraged them to report similar incidents in the future

• The participants' willingness to report violence hinges on their belief that the information will meaningfully strengthen paramedic safety.

Citation:

Mausz, J., Braaksma, M. J., Johnston, M., Batt, A. M., & Donnelly, E. A. (2024). Paramedic willingness to report violence following the introduction of a novel, point-of-event reporting process in a single Canadian paramedic service. International Journal of Enviornmental Research and Public Health, 21(3). 

This landmark study demonstrated that nearly half of the active-duty paramedic workforce in Peel Region experienced violence during the study period. For the first time, we have granular, event-level data on just how commonly paramedics are subjected to violence in the course of their duties. The full text of the paper is available for free without a subscription. 

Citation

Mausz, J., Johnston, M., Arseneau-Bruneau, D., Batt, A. M., & Donnelly, E. A. (2023). Prevalence and characteristics of violence against paramedics in a single Canadian site. International Journal of Environmental Research and Public Health, 20, 6644.

Our team debuted findings from the Region of Peel's innovative violence reporting process at the second annual Canadian Paramedicine Research Day held online on Thursday, May 25th, 2023. Over a two-year study period, 50% of the active-duty paramedics filed a violence report, 40% of reports documented a physical or sexual assault, and 81 paramedics (22% of those filing a report and 10% of the workforce) were physically injured after an assault. 

Citation

Mausz, J., Tavares, W., Johnston, M., Batt, A., & Donnelly, E. A. (2023). Violence against paramedics: Findings from a mixed methods research program. Podium presentation at the second annual Canadian Paramedicine Research Day, Toronto, Ontario: May 25, 2023.

Our paper Violence Against Paramedics: Protocol for Evaluating 2 Years of Reports Through a Novel, Point-of-Event Reporting Process has been published in the journal JMIR Research Protocols. This paper outlines the approach we are using in a mixed methods program of research into the prevalance of violence against paramedics, its contributing circumstnaces, characteristics, and risk factors. The full text is available for free online here. Read the Twitter thread and LinkedIn post.

Citation

Mausz, J., & Donnelly, E. A. (2023). Violence against paramedics: Protocol for evaluating two years of reports from a novel, point-of-event reporting process. JMIR Research Protocols, 12, e37636. DOI: https://doi.org/10.2196/37636

Our team presented a narrated poster on user experience feedback on our novel, point-of-event violence reporting process at the BC First Responder Mental Health Conference held in Richmond, British Columbia on January 26th & 27th, 2023.

Citation

Mausz, J., Braaksma, M. J., & Donnelly, E. A. (2023). Violence against paramedics: User experience feedback on a novel reporting process. Poster presentation at the BC First Responder Mental Health Conference, Richmond, BC, January 26-27, 2023.

Citation

Bradford, R., Donnelly, E. A., & Mausz, J. (2023). Violence against paramedics: is address hazard flagging useful? Poster presentation at the National Association of EMS Physicians (NAEMSP) Annual Meeting, Tampa, Florida, January, 26, 2023.

Our qualitative study on how the organizational culture within paramedicine normalizes exposure to workplace violence in the Journal of Conflict, Aggression, and Peace Research.

Citation

Mausz, J., Johnston, M., & Donnelly, E. A. (2021). The role of organizational culture in normalizing paramedic exposure to violence. Journal of Aggression, Conflict and Peace Research, ahead-of-print.

We have shared the results of our study into barriers to reporting at several local, national, and international conferences including

• The National Association of EMS Physicians (January 2021)

• The Canadian Institute for Military and Veteran Health Research (October 2021)

Citations

Mausz, J., Johnston, M., & Donnelly, E. A. (2021). The role of organizational culture in normalizing paramedic exposure to workplace violence. Poster presentation at the National Association of EMS Physicians (NAEMSP) Annual Meeting. Held virtually, January 11-16, 2021.

Mausz, J., Johnston, M., & Donnelly, E. A. (2021). The role of organizational culture in normalizing paramedic exposure to workplace violence. Podium presentation at the Canadian Institute for Military and Veteran Health Research (CIMVHR) Forum. Held vitually, October 25-27, 2021.

The catalyst for our collaborative External Violence Against Paramedics (EVAP) project: We presented at a special session of the Ontario Association of Paramedic Chiefs to spread the word about our collaboration and recruit partners. 

How it all started: After the seminal 2019 report, we began a lengthy stakeholder engagement and pilot testing process to develop what would become the External Violence Incident Report (EVIR). 

Recognizing that administrative 'red tape' was a barrier to reporting, we new that the EVIR would have to be "trip over accessible" in addition to complying with provincial documentation standards and perceived as valuable by the paramedics. 

The result was a novel, point-of-event reporting process developed in partnership with InterDev Technologies that is attached directly to the Electronic Patient Care Report (ePCR) to track incidents of violence perpetrated against paramedics.

Citation

Mausz, J., Johnston, M., & Donnelly, E. A. (2021). Development of a reporting process for violence against paramedics. Canadian Paramedicine, 4(1), p. 23-27

In 2019, we surveyed paramedics in Peel Region to ask about their experiences with workplace violence and reasons for underreporting. This seminal report launched what would become the External Violence Against Paramedics (EVAP) program that later included:

• Crisis prevention and intervention training for paramedics

• The development of the External Violence Incident Report

• A media awareness campaign 

• Back-of-house processes to identify and support paramedics who had been subjected to violence

Citation

Mausz, J. & Johnston, M. (2019). "Violence, in fact, is not part of the job" A qualitative study of paramedic experiences with workplace violence. Peel Regional Paramedic Services, Regional Municipality of Peel, Brampton, Ontario, Canada.