The Impact of Ambulance Workforce Practices on Prehospital Care Quality: A Comprehensive Review

Abstract

Ambulance workforce practices play a central role in determining the quality, safety, and effectiveness of prehospital emergency care. As demand for rapid medical response continues to grow worldwide, the expectations placed on ambulance teams have increased significantly, requiring high levels of clinical competency, teamwork, adaptability, and resilience. This review examines current evidence (2016–2025) on how ambulance workforce practices—including clinical skill maintenance, crew configuration, workload and shift design, communication dynamics, leadership, and psychological wellbeing—affect key aspects of prehospital care quality. A structured search of major databases identified studies that collectively highlight strong associations between workforce practices and clinical outcomes such as response times, decision-making accuracy, patient safety, and survival rates in time-critical emergencies. The review also explores moderating and mediating factors that influence workforce performance, including stress, fatigue, cognitive load, and contextual challenges such as urban–rural variability. Findings show that well-designed workforce systems, supported by continuous training, optimized staffing models, and robust wellbeing programs, significantly improve prehospital performance and patient outcomes. This review underscores the need for integrated workforce development strategies, policy reforms, and innovative approaches—including simulation-based training and digital decision-support tools—to enhance the future readiness of ambulance services.