PMID- 32007399
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20210728
IS  - 1938-131X (Electronic)
IS  - 1553-7250 (Linking)
VI  - 46
IP  - 4
DP  - 2020 Apr
TI  - Adverse Events Present on Arrival to the Emergency Department: The ED as a Dual 
      Safety Net.
PG  - 192-198
LID - S1553-7250(19)30486-6 [pii]
LID - 10.1016/j.jcjq.2019.12.003 [doi]
AB  - BACKGROUND: The emergency department (ED) is the natural venue for the provision 
      of acute unscheduled care. However, little is known about the nature and 
      proportion of this care that goes to addressing adverse events (AEs)-physical 
      injury to a patient due to health care that requires some intervention-that are 
      present on arrival (POA) to the ED. Described here are AEs that are POA, and 
      population prevalence estimates for these events. METHODS: This retrospective 
      observational study tested the ED Trigger Tool, using data from an urban academic 
      medical center. Patients aged >/=18 completing an ED visit were eligible 
      (N = 92,859). A total of 5,582 visits with triggers (findings that increase the 
      likelihood of an AE) were reviewed using the two-tier trigger approach. AEs were 
      categorized by severity, type, and whether they were POA. POA AEs, and 
      sociodemographic and trigger associations with AEs are described. RESULTS: Of 
      1,181 AEs identified, 718 (60.8%) were POA to the ED. Patients with POA AEs were 
      more often white (51.1% vs. 39.7%, p < 0.001) and older (median age 62 vs. 50, p 
      < 0.001). The majority of POA AEs were medication-related and patient 
      care-related events. In the population at this center, POA AEs account for an 
      estimated 7.6% of ED visits (95% confidence interval = 6.9%-8.2%). CONCLUSION: In 
      this single-center study, the majority of AEs detected using the ED Trigger Tool 
      were POA. These findings highlight the importance of the ED as a safety net for 
      harm occurring across the health system.
CI  - Copyright (c) 2019 The Joint Commission. Published by Elsevier Inc. All rights 
      reserved.
FAU - Griffey, Richard T
AU  - Griffey RT
FAU - Schneider, Ryan M
AU  - Schneider RM
FAU - Todorov, Alexandre A
AU  - Todorov AA
LA  - eng
GR  - R18 HS025052/HS/AHRQ HHS/United States
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20200118
PL  - Netherlands
TA  - Jt Comm J Qual Patient Saf
JT  - Joint Commission journal on quality and patient safety
JID - 101238023
SB  - IM
MH  - *Emergency Service, Hospital
MH  - Humans
MH  - Middle Aged
MH  - Retrospective Studies
EDAT- 2020/02/03 06:00
MHDA- 2021/07/29 06:00
CRDT- 2020/02/03 06:00
PHST- 2019/08/20 00:00 [received]
PHST- 2019/12/06 00:00 [revised]
PHST- 2019/12/16 00:00 [accepted]
PHST- 2020/02/03 06:00 [pubmed]
PHST- 2021/07/29 06:00 [medline]
PHST- 2020/02/03 06:00 [entrez]
AID - S1553-7250(19)30486-6 [pii]
AID - 10.1016/j.jcjq.2019.12.003 [doi]
PST - ppublish
SO  - Jt Comm J Qual Patient Saf. 2020 Apr;46(4):192-198. doi: 
      10.1016/j.jcjq.2019.12.003. Epub 2020 Jan 18.