M Thomas1, R Morton, K Mackway-Jones. 1. Emergency Department, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
Abstract
OBJECTIVES: To identify common risk types occurring in emergency departments (EDs). To compare the risks occurring between different emergency departments. DESIGN: Application of a typology of risks to a database of critical incidents. Comparison of results of applying typology to group of critical incidents collected in a uniform manner in four different EDs. SETTING: EDs in two teaching hospitals and two district general hospitals in the north west of England. INTERVENTIONS: Observational study. MAIN OUTCOME MEASURES: Types of critical incidents identified. Statistical comparisons between EDs. RESULTS: 816 critical incidents were classified. Patient assessment omission failures were the commonest type of failure, accounting for 291 (35.6%) of the critical incidents. Level 1 and level 2 failures accounted for 254 (31.1%) of critical incidents. Significant differences (p = 0.009) were shown between EDs when the categories of critical incidents occurring were compared. No significant differences (p = 0.336) were shown between EDs when the levels of severity of critical incidents occurring were compared. CONCLUSIONS: Large numbers of critical incidents with potentially fatal consequences occur. The types of risks differ significantly between different EDs.
OBJECTIVES: To identify common risk types occurring in emergency departments (EDs). To compare the risks occurring between different emergency departments. DESIGN: Application of a typology of risks to a database of critical incidents. Comparison of results of applying typology to group of critical incidents collected in a uniform manner in four different EDs. SETTING: EDs in two teaching hospitals and two district general hospitals in the north west of England. INTERVENTIONS: Observational study. MAIN OUTCOME MEASURES: Types of critical incidents identified. Statistical comparisons between EDs. RESULTS: 816 critical incidents were classified. Patient assessment omission failures were the commonest type of failure, accounting for 291 (35.6%) of the critical incidents. Level 1 and level 2 failures accounted for 254 (31.1%) of critical incidents. Significant differences (p = 0.009) were shown between EDs when the categories of critical incidents occurring were compared. No significant differences (p = 0.336) were shown between EDs when the levels of severity of critical incidents occurring were compared. CONCLUSIONS: Large numbers of critical incidents with potentially fatal consequences occur. The types of risks differ significantly between different EDs.
Authors: T A Brennan; L L Leape; N M Laird; L Hebert; A R Localio; A G Lawthers; J P Newhouse; P C Weiler; H H Hiatt Journal: N Engl J Med Date: 1991-02-07 Impact factor: 91.245