OCA Audit Reports

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Issued: March 2005

SUMMARY

The combination of higher EMS lost time injury rate and the rise in EMS claim costs suggests that there remains a need to take strong proactive measures to enhance the safety of EMS employees. We reviewed the EMS lost time injury (LTI) rate and cost associated with these injuries for the fiscal years since the original audit was issued, beginning with FY2001. The data indicate that, despite an initial decrease in the EMS LTI rate, the most recent measurement is slightly higher than the rate when the original audit was issued.

Since the original audit was issued in April of 2001, the cost of EMS injury claims rose $86,778, an increase of 21.6 percent. The city-wide claim cost increased 18.5 percent during this same period. Also, while EMS comprises only 3.14 percent of the City workforce in FY2004 they account for 6.01 percent of the city-wide cost of claims.

By testing the implementation status of the audit recommendations issued in 2001, we also intended to provide information on current issues related to EMS employee safety.

Our findings indicate that three of our original recommendations are fully implemented and six are partially implemented. Our observations show that EMS:

• has developed and implemented a supplemental injury form aimed at categorical descriptions related to the injury;
• has implemented several performance measures that can track the results of efforts to reduce employee injuries;
• investigates a variety of employee injuries, in addition to vehicle accidents and infectious diseases;
• has established a Safety Committee that has recently begun functioning as intended and is actively working toward the reduction of injury incidents in the workplace; and
• is revising and updating the department’s existing Accident Prevention Plan (APP) through the Safety Committee.

However, we also found that:

• Although EMS injury and safety data is being collected currently, the data is not being consistently tracked, investigated, analyzed, or systematically reported to top management in a way that injury trends can be easily discerned. Such reports are now only on an ad hoc basis to the Safety Committee;
• The supplemental injury form does not focus on the root causes, preventability, or safety issues related to the injury;
• EMS does not assess the physical fitness of paramedics once they have graduated from the academy or have returned to full duty status following an on the job injury.

We are in agreement with EMS management that efforts are “underway” on the four recommendations that we show as partially implemented, and that three other recommendations have been fully implemented. However, we believe there remains two areas where EMS is reporting the recommendations as implemented, while we concluded both recommendations are only partially implemented. It is our judgment that EMS management has not implemented an effective injury reporting format and should update and revise its current injury investigation process to place more emphasis on causes and preventability of injuries. Secondly, we do not believe EMS effectively utilizes mid-level supervisors (commanders) to reinforce employee safety. EMS should strengthen its accountability for supervisors whose activities in the field can affect three main causes of injury on the job: imprecise execution of physical work, employee negligence, and failure to follow approved safety practices.

Download the entire text of our EMS Employee Safety Follow-up audit Report (Size: 479 KB) in Adobe Acrobat. You will need Adobe's Acrobat Reader to view these files. Or request a hard copy of this audit report, No. AU04201, by submitting this audit report request form.

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