Experience in Adverse Events Detection in an Emergency Department: Incidence and Outcome of Events

Emerg Med Australas. 2007 Feb;19(1):16-24. doi: 10.1111/j.1742-6723.2006.00896.x.

Abstract

Objectives: The study was performed to determine the incidence, outcome and preventability of adverse events (AE) in an ED.

Methods: The Quality in Australian Health Care Study methodology, modified to the ED, was utilized. Case histories of patients presenting to a tertiary hospital ED were screened for events. Events detected were classified, using a 104-item data collection instrument, entered on Excel and analysed statistically using MINITAB.

Results: A total of 5345 patients presented during the study period. Three thousand three hundred and thirty-two patients completed full evaluation and comprised the study population. One hundred and ninety-four events were detected. Except where specified, events with management causation < or = 3 were excluded. This excluded 24 events (12.4%) leaving 170 for analysis. Of patients suffering an event, 53.5% occurred prior ED attendance, 41.7% of AE occurred within the ED, and 4.7% had contributions from both. The overall event rate, detected by the screening process, was 5.1%, with an incident rate of 1.98% and AE rate of 3.12%. The ED AE rate was 1.0%. If only those with management causation = 1 are excluded, then the overall event rate was 5.52%, with an AE rate of 3.33%. Fifty-five per cent of events were judged to be preventable (preventability score > or = 3). Events resulting in death and disability were more likely to be preventable (P < or = 0.04).

Conclusion: In conclusion, the Quality in Australian Health Care Study methodology has been utilized to provide data on incidents and AE in an ED.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / standards
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Incidence
  • Male
  • Medical Errors / adverse effects
  • Medical Errors / prevention & control
  • Medical Errors / statistics & numerical data*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Retrospective Studies