Christian Hohenstein1, Dorothea Hempel2, Kerstin Schultheis3, Oliver Lotter4, Thomas Fleischmann5. 1. Department of Emergency Medicine, University Hospital Jena, Jena, Germany. 2. Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. 3. Department of Medicine, University Hospital Gießen, Gießen, Germany. 4. Department of Trauma and Plastic Surgery, BG Unfallklinik Tuebingen, Tuebingen, Germany. 5. Department of Emergency Medicine, Salzgitter Hospital, Salzgitter, Germany.
Abstract
BACKGROUND: Medical errors frequently contribute to morbidity and mortality. Prehospital emergency medicine is prone to incidents that can lead to immediate deadly consequences. Critical incident reporting can identify typical problems and be the basis for structured risk management in order to reduce and mitigate these incidents. METHODS: We set up a free access internet website for German-speaking countries, with an anonymous reporting system for emergency medical services personnel. After a 7-year study period, an expert team analysed and classified the incidents into staff related, equipment related, organisation and tactics, or other. RESULTS: 845 reports were entered in the study period. Physicians reported 44% of incidents, paramedics 42%. Most patients were in a life-threatening or potentially life-threatening situation (82%), and only 53% of all incidents had no influence on the outcome of the patient. Staff-related problems were responsible for 56% of the incidents, when it came to harm, 78% of these incidents were staff related. CONCLUSIONS: Incident reporting in prehospital emergency medicine can identify system weaknesses. Most of the incidents were reported during care of patients in life-threatening conditions with a high impact on patient outcome. Staff-related problems contributed to the most frequent and most severe incidents. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Medical errors frequently contribute to morbidity and mortality. Prehospital emergency medicine is prone to incidents that can lead to immediate deadly consequences. Critical incident reporting can identify typical problems and be the basis for structured risk management in order to reduce and mitigate these incidents. METHODS: We set up a free access internet website for German-speaking countries, with an anonymous reporting system for emergency medical services personnel. After a 7-year study period, an expert team analysed and classified the incidents into staff related, equipment related, organisation and tactics, or other. RESULTS: 845 reports were entered in the study period. Physicians reported 44% of incidents, paramedics 42%. Most patients were in a life-threatening or potentially life-threatening situation (82%), and only 53% of all incidents had no influence on the outcome of the patient. Staff-related problems were responsible for 56% of the incidents, when it came to harm, 78% of these incidents were staff related. CONCLUSIONS: Incident reporting in prehospital emergency medicine can identify system weaknesses. Most of the incidents were reported during care of patients in life-threatening conditions with a high impact on patient outcome. Staff-related problems contributed to the most frequent and most severe incidents. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
emergency ambulance systems; paramedics; prehospital care, doctors in PHC; quality assurance; risk management
Authors: Magnus Andersson Hagiwara; Carl Magnusson; Johan Herlitz; Elin Seffel; Christer Axelsson; Monica Munters; Anneli Strömsöe; Lena Nilsson Journal: BMC Emerg Med Date: 2019-01-24
Authors: Josephine Hegarty; Sarah Jane Flaherty; Mohamad M Saab; John Goodwin; Nuala Walshe; Teresa Wills; Vera J C McCarthy; Siobhan Murphy; Alana Cutliffe; Elaine Meehan; Ciara Landers; Elaine Lehane; Aoife Lane; Margaret Landers; Caroline Kilty; Deirdre Madden; Mary Tumelty; Corina Naughton Journal: J Patient Saf Date: 2021-12-01 Impact factor: 2.243