A qualitative study on the relationship between leadership and clinical skills in paramedicine and the promotion of patient safety

This study aims to investigate and describe the relationship between acquired leadership capability and clinical performance in the out-of-hospital environment (OOH) and to identify and explore those key themes that might influence a relationship between paramedic leadership aptitude and patient safety. This study employed a qualitative descriptive design using a combination of purposive and convenience sampling. Data collection occurred via semi-structured interviews conducted over teleconference. Qualitative thematic analysis was chosen with an inductive orientation, semantic focus of meaning, and experiential framework taken to coding and theme generation. This methodology facilitated the discovery and analysis of the participant's personal experiences with the interconnectedness of leadership and clinical skills and the associated implications to patient safety. Data was collected from seven registered paramedics, all of whom were working for public sector ambulance services as specialist, advanced care paramedics. Five primary themes emerged: (1) discovery of human factors, (2) knowledge growth is formal and informal, (3) working smarter, (4) leadership expectations and usefulness and (5) transparency of errors. These themes underpin the importance of, and provide constructive insights into, the relationship between leadership and clinical skills in paramedicine and the impact on patient safety. This research has identified that those non-technical skills (NTS) including that of leadership employed in paramedicine are inextricably linked and of equal importance to those technical clinical skills The assessment of a paramedic's NTS against a required standard in a similar way to a technical skill, is important when considering practice competency policies moving forward.