Organizational strategies to address post-traumatic stress injuries among Canadian paramedics.

BACKGROUND Paramedics are a high-risk occupational group for post-traumatic stress injuries (PTSI), and increasingly, evidence suggests that organizational factors play a significant role. While several resources for paramedic services to address PTSI exist, there is limited knowledge as to which PTSI-related programs and practices are implemented and how they are perceived in the workplace. OBJECTIVES This research aimed to explore key informants' perspectives on existing and desired organizational-wide initiatives for, as well as the challenges and potential solutions to, the primary prevention, early detection and intervention, and disability management of PTSI in Canadian paramedic services. METHODS Semi-structured interviews were conducted with 12 key informants from jurisdictions across Canada who have over five years of work experience in prehospital care. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. RESULTS Eight recurrent organizational elements (themes) for addressing PTSI emerged: psychologically safe and healthy work culture; consistent supervisor support, mental health training and awareness, opportunities for recovery and maintaining resiliency, recognition of PTSI and its diverse risk factors, access to a variety of support initiatives for PTSI, communication during medical leave, and meaningful work accommodations. CONCLUSIONS While organizational-wide initiatives were in place for the primary prevention, early detection and intervention, and disability management of PTSI, systemic challenges with coordination, resource allocation, and worker engagement were also identified. These challenges prevented paramedic services from optimally addressing PTSI in their workplace. Integrating considerations from the eight organizational elements to address PTSI into broader existing management systems may have merit in overcoming the systemic challenges.