Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16582
Title: Case-control study to investigate variables associated with incidents and adverse events in the emergency department
Austin Authors: Hendrie, James;Yeoh, Michael J ;Richardson, Joanna R;Blunt, Andrew;Davey, Peter;Taylor, David McD ;Ugoni, Antony
Affiliation: Department of Emergency Medicine, Austin Health, Heidelberg, Victoria, Australia
Clinical Information Analysis and Reporting, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
Issue Date: Apr-2017
metadata.dc.date: 2017-01-24
Publication information: Emergency Medicine Australasia : EMA 2017; 29(2): 149-157
Abstract: OBJECTIVE: To detect and analyse incidents (Is) and adverse events (AEs) in the ED. We hypothesised that I/AE are associated with patient load. METHODS: We undertook a case-control study in a tertiary level hospital ED (from 1 April 2012 to 31 March 2013). Three percent of patients were randomly selected and screened for I/AEs. I/AEs were adjudicated by consensus of four FACEMs. Controls were matched to cases 2:1. Logistic regression was used to analyse the data. RESULTS: We sampled 2167 patients. After exclusions, 217 I/AEs were detected and analysed. The I and AE rates were 6.0 and 4.1%, respectively. The serious AE rate was 0.8% and 30 day mortality was 0.1%. Diagnostic error occurred in 3.7% of all patients and adverse drug reactions in 2.5%. Seventy-seven percent of the I/AEs were judged preventable. ED occupancy of <35 patients was the reference group. Compared with this group, if 36-40 or 41-45 patients were in the ED, I/AEs were more likely to occur (odds ratio [OR] 2.37 [95% confidence interval (CI) 1.40-4.01, P < 0.0] and 1.8 [95% CI 1.03-3.15, P = 0.04], respectively) but not when there were >46 patients (OR 1.7, 95% CI 1.0-3.1). Higher hospital occupancy (90-99%) was a protective factor for sustaining an I/AE (OR 0.57, 95% CI 0.35-0.92, P = 0.02). CONCLUSION: I/AEs are common in the ED and a large proportion is preventable. Strategies for prevention are required. The relationship with patient load needs further clarification, since our data suggests increased I/AE rates with higher occupancy but not highest occupancy.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16582
DOI: 10.1111/1742-6723.12736
ORCID: 0000-0002-8986-9997
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/28118693
Type: Journal Article
Subjects: Diagnostic error
Drug-related side-effects and adverse drug reaction
Emergency service hospital
Human
Medical error
Appears in Collections:Journal articles

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