Recovering from distress : the impact of critical incidents on paramedic work performance

Abstract

In many service operations settings, the difficulty of jobs is unpredictable. Examples include police officers or paramedics routinely responding to calls with only limited understanding of the situations awaiting them. In such settings, a worker may occasionally encounter a critical incident (CI), defined as a task or situation which is sufficiently disturbing to challenge or overwhelm the workers' usual coping mechanisms. We study the impact of complex, stress-inducing tasks on operational task performance of the ambulance crew at the London Ambulance Services (LAS). Our metric for operational performance is cycle times, an important driver of system utilization. Shorter cycle times indicate better performance. From analyzing the LAS data, we found that following a Cl, a crew's cycle times increase and the effect gets worse for teams which face more CIs within the same shift. We find that this effect is non-uniform over sub-components of cycle times. In particular, the impact is more significant on operational performance of complex and less standardized tasks. We also did a robustness check for varying definitions of a Cl and the results hold and are consistent.