Cathelijne Lyphout1, Jochen Bergs2, Willem Stockman3, Koen Deschilder4, Christophe Duchatelet5, Didier Desruelles6, Koen Bronselaer7. 1. Emergency Department, University Hospital Ghent, Ghent, Belgium. Electronic address: cathelijne.lyphout@uzgent.be. 2. Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium. Electronic address: jochen.bergs@uhasselt.be. 3. ICU department en MICU Roeselare, AZ Delta, Roeselare, Belgium. Electronic address: Willem.Stockman@azdelta.be. 4. ICU department en MICU Roeselare, AZ Delta, Roeselare, Belgium. Electronic address: Koen@paramedicalassistance.be. 5. Emergency Department, University Hospital Ghent, Ghent, Belgium. Electronic address: Christophe.duchatelet@ugent.be. 6. Emergency Department, University Hospitals Leuven, Leuven, Belgium. Electronic address: didier.desruelles@uzleuven.be. 7. Emergency Department, University Hospitals Leuven, Leuven, Belgium. Electronic address: koen.bronselaer@uzleuven.be.
Abstract
INTRODUCTION: Interhospital transport of critically ill patients is at risk of complications. The objective of the study was to prospectively record patient safety incidents that occurred during interhospital transports and to determine their risk factors. METHODS: We prospectively collected data during a fifteen-month period in 2 hospitals. Patient and transport characteristics were collected using a specifically designed tool. Patient safety incidents were appraised for health-care associated harm, and categorized as technical, operational, and communication problems. RESULTS: Our study included 688 patients who were transferred to or from one of both hospitals by physician or nurse led transport, with complete records. A patient safety incident was reported in 16.7% of transports, health-care associated harm was noted in 3.9% of cases. In multivariate analysis, three factors remained significantly associated with an increased risk of healthcare-associated harm: operational incidents (odds ratio=144.93, 95% CI=37.55-767.50, P<0.001), communication incidents (odds ratio=11.05, 95% CI=3.02-52.99, P<0.001) and the Modified Sequential Organ Failure Assessment (M-SOFA) score (odds ratio=1.198, 95% CI=1.038-1.40, P=0.017). CONCLUSIONS: The observed rate of patient safety incidents during interhospital transfers is lower than previously reported in the literature. However, there is limited previous work done on this topic. Operational and communication incidents, and a higher M-SOFA score are significantly associated with increase odds of harmful incident. These findings call for stricter preparation of transfers, with clear and standardized communication.
INTRODUCTION: Interhospital transport of critically illpatients is at risk of complications. The objective of the study was to prospectively record patient safety incidents that occurred during interhospital transports and to determine their risk factors. METHODS: We prospectively collected data during a fifteen-month period in 2 hospitals. Patient and transport characteristics were collected using a specifically designed tool. Patient safety incidents were appraised for health-care associated harm, and categorized as technical, operational, and communication problems. RESULTS: Our study included 688 patients who were transferred to or from one of both hospitals by physician or nurse led transport, with complete records. A patient safety incident was reported in 16.7% of transports, health-care associated harm was noted in 3.9% of cases. In multivariate analysis, three factors remained significantly associated with an increased risk of healthcare-associated harm: operational incidents (odds ratio=144.93, 95% CI=37.55-767.50, P<0.001), communication incidents (odds ratio=11.05, 95% CI=3.02-52.99, P<0.001) and the Modified Sequential Organ Failure Assessment (M-SOFA) score (odds ratio=1.198, 95% CI=1.038-1.40, P=0.017). CONCLUSIONS: The observed rate of patient safety incidents during interhospital transfers is lower than previously reported in the literature. However, there is limited previous work done on this topic. Operational and communication incidents, and a higher M-SOFA score are significantly associated with increase odds of harmful incident. These findings call for stricter preparation of transfers, with clear and standardized communication.
Authors: Jeffrey R Dichter; Asha V Devereaux; Charles L Sprung; Vikramjit Mukherjee; Jason Persoff; Karyn D Baum; Douglas Ornoff; Amit Uppal; Tanzib Hossain; Kiersten N Henry; Marya Ghazipura; Kasey R Bowden; Henry J Feldman; Mitchell T Hamele; Lisa D Burry; Anne Marie O Martland; Meredith Huffines; Pritish K Tosh; James Downar; John L Hick; Michael D Christian; Ryan C Maves Journal: Chest Date: 2021-09-06 Impact factor: 9.410