PMID- 32853517
OWN - NLM
STAT- MEDLINE
DCOM- 20220223
LR  - 20230928
IS  - 1549-8425 (Electronic)
IS  - 1549-8417 (Linking)
VI  - 18
IP  - 1
DP  - 2022 Jan 1
TI  - Analysis of Risk Factors for Patient Safety Events Occurring in the Emergency 
      Department.
PG  - e124-e135
LID - 10.1097/PTS.0000000000000715 [doi]
AB  - OBJECTIVE: The aim of the study was to describe and analyze the risk factors 
      associated with patient safety events (PSEs), defined as adverse events (AEs), 
      preventable AEs (PAEs), and near-miss events (NMEs), in the emergency department 
      (ED). METHODS: It was a retrospective cohort study using ED patients' data 
      retrieved from January 2010 to December 2016. Quality assurance issues (QAIs) 
      used as triggers included the following: issues during procedural sedation, death 
      within 24 hours of admission, patients' and physicians' complaints, returns to 
      the ED within 72 hours, and transfers to an intensive care unit within 24 hours. 
      RESULTS: Of 383,586 ED visits, 6519 (1.7%) QAIs were reported with a PSEs 
      incidence of 6.1%. Among the 397 PSEs, 258 were AEs including 82 PAEs, and 139 
      NMEs. During the 7-year period, we observed a fourfold increase in NMEs, and 
      despite a decrease in the rate of AEs with the highest (3.1%) and lowest (0.8%) 
      incidence in 2011 and 2016, respectively, the incidence of PAEs events remained 
      relatively constant. Unadjusted analysis showed that ED waiting time, boarding 
      time, ED length of stay (LOS), ED disposition, as well as diagnostic and QAIs 
      were significantly related to PSEs (P < 0.05). Multivariable analysis showed that 
      the type of QAIs and diagnostic were associated with PSEs (P < 0.001). Type of 
      QAIs was a risk factor for AEs and PAEs occurrence and factors involved in NMEs 
      were type of QAIs (P = 0.02) and ED LOS (P < 0.001). "The odds of a PSE occurring 
      increased by 0.2% for each additional minute increase in the ED waiting time, by 
      5.2% for each additional boarding hour, and by 4.5% for each ED LOS hour." 
      CONCLUSIONS: This study showed several potential risk factors for PSEs, 
      especially ED LOS, type of QAIs, and diagnostic. Systematic interventions might 
      have more impact on risk of PSE.
CI  - Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Alsabri, Mohamed
AU  - Alsabri M
AD  - From the Emergency Medicine Department, Beth Israel Deaconess Medical Center, 
      Teaching Hospital of Harvard Medical School, Harvard Medical School, Boston, 
      Massachusetts.
FAU - Boudi, Zoubir
AU  - Boudi Z
AD  - Department of Emergency Medicine, Emergency Medicine Department, Dr Sulaiman 
      Alhabib Hospital, Dubai, United Arab Emirates.
FAU - Zoubeidi, Taoufik
AU  - Zoubeidi T
AD  - Department of Statistics, College of Business and Economics, UAE University, Al 
      Ain, United Arab Emirates.
FAU - Alfaki, Ibrahim Abdalla
AU  - Alfaki IA
AD  - Department of Statistics, College of Business and Economics, UAE University, Al 
      Ain, United Arab Emirates.
FAU - Levy, Phillip
AU  - Levy P
AD  - Department of Emergency Medicine and Integrative Biosciences Center, Wayne State 
      University, Detroit, Michigan.
FAU - Oneyji, Churchill
AU  - Oneyji C
AD  - From the Emergency Medicine Department, Beth Israel Deaconess Medical Center, 
      Teaching Hospital of Harvard Medical School, Harvard Medical School, Boston, 
      Massachusetts.
FAU - Shan, Liu
AU  - Shan L
AD  - Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical 
      School, Boston, Massachusetts.
FAU - Camargo, Carlos A Jr
AU  - Camargo CA Jr
AD  - Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical 
      School, Boston, Massachusetts.
FAU - Michel, Philippe
AU  - Michel P
FAU - Tazarourte, Karim
AU  - Tazarourte K
FAU - Hachimi-Idrissi, Said
AU  - Hachimi-Idrissi S
AD  - Department of Emergency Medicine, Ghent University Hospital, Gent, Belgium.
FAU - Grossman, Shamai
AU  - Grossman S
AD  - From the Emergency Medicine Department, Beth Israel Deaconess Medical Center, 
      Teaching Hospital of Harvard Medical School, Harvard Medical School, Boston, 
      Massachusetts.
FAU - Bellou, Abdelouahab
AU  - Bellou A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Patient Saf
JT  - Journal of patient safety
JID - 101233393
SB  - IM
MH  - *Emergency Service, Hospital
MH  - Humans
MH  - Length of Stay
MH  - Patient Admission
MH  - *Patient Safety
MH  - Retrospective Studies
MH  - Risk Factors
COIS- The authors disclose no conflict of interest.
EDAT- 2020/08/28 06:00
MHDA- 2022/02/24 06:00
CRDT- 2020/08/28 06:00
PHST- 2020/08/28 06:00 [pubmed]
PHST- 2022/02/24 06:00 [medline]
PHST- 2020/08/28 06:00 [entrez]
AID - 01209203-202201000-00026 [pii]
AID - 10.1097/PTS.0000000000000715 [doi]
PST - ppublish
SO  - J Patient Saf. 2022 Jan 1;18(1):e124-e135. doi: 10.1097/PTS.0000000000000715.