Review article: A systematic review of emergency department incident classification frameworks
- 11 October 2017
- journal article
- review article
- Published by Wiley in Emergency Medicine Australasia
- Vol. 30 (3), 293-308
- https://doi.org/10.1111/1742-6723.12864
Abstract
As in any part of the hospital system, safety incidents can occur in the ED. These incidents arguably have a distinct character, as the ED involves unscheduled flows of urgent patients who require disparate services. To aid understanding of safety issues and support risk management of the ED, a comparison of published ED specific incident classification frameworks was performed. A review of emergency medicine, health management and general medical publications, using Ovid SP to interrogate Medline (1976–2016) was undertaken to identify any type of taxonomy or classification-like framework for ED related incidents. These frameworks were then analysed and compared. The review identified 17 publications containing an incident classification framework. Comparison of factors and themes making up the classification constituent elements revealed some commonality, but no overall consistency, nor evolution towards an ideal framework. Inconsistency arises from differences in the evidential basis and design methodology of classifications, with design itself being an inherently subjective process. It was not possible to identify an ‘ideal’ incident classification framework for ED risk management, and there is significant variation in the selection of categories used by frameworks. The variation in classification could risk an unbalanced emphasis in findings through application of a particular framework. Design of an ED specific, ideal incident classification framework should be informed by a much wider range of theories of how organisations and systems work, in addition to clinical and human factors.Funding Information
- Houston Advanced Research Center
- Emergency Care Institute (ECI)
- Sax Institute in partnership with the Clinical Excellence Commission
- Agency for Clinical Innovation and the Bureau of Health Information in NSW, Australia
This publication has 38 references indexed in Scilit:
- Creating an Infrastructure for Safety Event Reporting and Analysis in a Multicenter Pediatric Emergency Department NetworkPediatric Emergency Care, 2013
- Frequency and nature of reported incidents during Emergency Department careEmergency Medicine Journal, 2010
- The Safety of Emergency Care Systems: Results of a Survey of Clinicians in 65 US Emergency DepartmentsAnnals of Emergency Medicine, 2009
- The Effect of Clinical Experience on the Error Rate of Emergency PhysiciansAnnals of Emergency Medicine, 2008
- Testing a classification model for emergency department errorsJournal of Advanced Nursing, 2006
- Anatomy of a patient safety event: a pediatric patient safety taxonomyHeart, 2005
- Cause‐and‐effect Analysis of Risk Management Files to Assess Patient Care in the Emergency DepartmentAcademic Emergency Medicine, 2004
- A framework for classifying factors that contribute to error in the emergency departmentAnnals of Emergency Medicine, 2003
- Errors in a busy emergency departmentAnnals of Emergency Medicine, 2003