Strengthening emergency medical service workforce resilience in Thailand: Integrating frontline and decision-maker perspectives.
Australasian emergency care · 2026-07-23 · Qualitative study
Abstract
BACKGROUND: Emergency medical service (EMS) providers play a critical role in delivering timely prehospital care and rely on a resilient workforce to respond effectively to emergencies. This study aimed to integrate frontline and decision-maker perspectives to identify key challenges and opportunities for strengthening EMS workforce resilience in Thailand. METHODS: Data were derived from a nationwide survey of 500 EMS personnel, including open-ended responses, and semi-structured interviews with six EMS decision-makers. Secondary content analysis was conducted to examine frontline perspectives, while primary thematic analysis of interviews was performed using NVivo. Findings were integrated to identify system-level priorities for strengthening EMS workforce resilience. RESULTS: Qualitative analyses identified challenges across five key domains: wellness, safety, competence, structure and resources, and policy and governance. Frontline providers reported high workload, mental health strain, and resource limitations. Decision-makers highlighted gaps in workforce planning, training, coordination, and governance. Integration of both perspectives identified system-level priorities for strengthening EMS workforce resilience. CONCLUSION: Strengthening EMS workforce resilience requires coordinated organizational and policy interventions that address workforce wellbeing, operational capacity, and governance simultaneously. The findings provide evidence to support workforce planning and health system resilience in Thailand.