Ambulance professionals’ perceptions of teamwork and patient safety culture: a TeamSTEPPS intervention study

Abstract Background Patient safety depends fundamentally on effective teamwork, particularly in the high-risk, time-critical environment of ambulance services. However, research on how ambulance professionals (APs) perceive teamwork and patient safety culture remains limited. This study explored APs’ perceptions of teamwork and patient safety culture during a TeamSTEPPS team training intervention with data collection at baseline, 4 months, and 12 months, and examined whether perceptions differed by demographic characteristics or workplace. Methods We employed a repeated cross-sectional questionnaire design among APs from seven ambulance stations in south-eastern Norway. The TeamSTEPPS programme included a full one-day introduction, four months of structured team training focusing on the four teamwork skills: Communication, Leadership, Situation Monitoring, and Mutual Support, and a three-month sustainment phase. Measurements at baseline, 4 months, and 12 months were obtained using the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) and the Prehospital Survey on Patient Safety Culture (PreHSOPSC). Data were analysed using independent-samples t-test, ANOVA, and multivariate analysis of covariance. Results The response rate for the three time points was 86.5% (90/104), 62.7% (64/102), and 52.7% (48/91). At baseline, T-TPQ scores were neutral to positive, with Leadership rated lowest (mean 3.26, SD 0.69) and Situation Monitoring highest (mean 4.06, SD 0.45). PreHSOPSC scores at baseline were more variable, with Frequency of Error Reporting rated lowest (mean 2.56, SD 0.71) and Stop Working in Dangerous Situations highest (mean 4.11, SD 0.51). No statistically significant changes were observed in any dimension of teamwork or patient safety culture from baseline to 4 or 12 months after initiation of the team training. Conclusions Ambulance professionals in this study perceived teamwork more favourably than patient safety culture, with the latter showing wider variation between dimensions. No significant differences were observed across the three time points spanning the TeamSTEPPS intervention. The dimensions Leadership (T-TPQ) and Frequency of Error Reporting (PreHSOPSC) had the greatest potential for improvement in their respective categories. Improving perceptions of teamwork and patient safety culture in ambulance services may require a multifaceted approach that targets system-level interventions and organisational strategies. Trial registration ClinicalTrials.gov—ID: NCT05244928.