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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2009 | Original research

Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations

Authors: Amir Khorram-Manesh, Annika Hedelin, Per Örtenwall

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2009

Abstract

Background

A hospital's capacity and preparedness is one of the important parts of disaster planning. Hospital-related incidents, a new phenomenon in Swedish healthcare, may lead to ambulance diversions, increased waiting time at emergency departments and treatment delay along with deterioration of disaster management and surge capacity. We aimed to identify the causes and impacts of hospital-related incidents in Region Västra Götaland (western region of Sweden).

Methods

The regional registry at the Prehospital and Disaster Medicine Center was reviewed (2006–2008). The number of hospital-related incidents and its causes were analyzed.

Results

There were an increasing number of hospital-related incidents mainly caused by emergency department's overcrowdings, the lack of beds at ordinary wards and/or intensive care units and technical problems at the radiology departments. These incidents resulted in ambulance diversions and reduced the prehospital capacity as well as endangering the patient safety.

Conclusion

Besides emergency department overcrowdings, ambulance diversions, endangering patient s safety and increasing risk for in-hospital mortality, hospital-related incidents reduces and limits the regional preparedness by minimizing the surge capacity. In order to prevent a future irreversible disaster, this problem should be avoided and addressed properly by further regional studies.

Available only for authorised users

Prehospital and Disaster Medicine Centre. Västra Götalandsregion, Sweden. 2009, [http://www.vgregion.se/sv/Regionkansliet/Prehospitalt-och-Katastrofmedicinskt-Centrum/In-English/]

Richardson DB: Reducing patient time in the emergency department. MJA. 2003, 179: 516-7.PubMed

McConnell KJ, Richards CF, Daya M, Bernell SL, Weathers CC, Lowe RA: Effect of Increased ICU Capacity on Emergency Department Length of Stay and Ambulance Diversion. Ann Emerg Med. 2005, 45: 471-8. 10.1016/j.annemergmed.2004.10.032.CrossRefPubMed

Cowan R, Trzeciak S: Clinical review: Emergency department overcrowding and the potential impact on the critically ill. Critical care. 2005, 9: 291-5. 10.1186/cc2981.PubMedCentralCrossRefPubMed

Baer RB, Pasternack JS, Zwemer FL: Recently Discharged Inpatients as a Source of Emergency Department Overcrowding. Acad Emerg Med. 2001, 8: 1091-94. 10.1111/j.1553-2712.2001.tb01121.x.CrossRefPubMed

Hess EP, Wells GA, Jaffe A, Stiell IG: A study to derive a clinical decision rule for triage of emergency department patients with chest pain: design and methodology. BMC Emerg Med. 2008 Feb 6;8:3. 2008, 8: 3-

Kaji AH, Koenig KL, Lewis RJ: Current Hospital Disaster Preparedness. JAMA. 2007, 298: 2188-90. 10.1001/jama.298.18.2188.CrossRefPubMed

Fatovich DM, Hirsch RL: Entry overload, emergency department overcrowding, and ambulance bypass. Emerg Med J. 2003, 20: 406-9. 10.1136/emj.20.5.406.PubMedCentralCrossRefPubMed

Sun BC, Mohanty SA, Weiss R, Tadeo R, Hasbrouck M, Koenig W, Meyer C, Asch S: Effects of Hospital Closure and Hospital Characteristics on Emergency Department Ambulance Diversion, Los Angeles County, 1988 to 2004. Ann Emerg Med. 2006, 47: 309-16. 10.1016/j.annemergmed.2005.12.003.CrossRefPubMed

10.

Saltwater AB: Sweden. 2009, [http://www.saltwater.se]

11.

Estey A, Ness K, Saunders LD, Alibhai A, Bear RA: Understanding the causes of overcrowding in emergency departments in the Capital Health Region in Alberta: a focus group study. CJEM. 2003, 5: 87-94.PubMed

12.

Fatovich DM, Nagree Y, Sprivulis P: Access block causes emergency department overcrowding and ambulance diversion in Perth, Western Australia. Emerg Med J. 2005, 22: 351-4. 10.1136/emj.2004.018002.PubMedCentralCrossRefPubMed

13.

Baylay MD, Schwartz JS, Shofer FS, Weiner M, Sites FD, Traber KB, Hollander JE: The financial burden of emergency department congestion and hospital crowding for chest pain patients awaiting admission. Ann Emerg Med. 2005, 45: 110-17. 10.1016/j.annemergmed.2004.09.010.CrossRef

14.

OECD Health Data. 2008, [http://www.oecd.org/]

15.

Barbisch DF, Koenig KL: Understanding surge capacity: essential elements. Acad Emerg Med. 2006, 13: 1098-102.CrossRefPubMed

16.

Kaji AH, Lewis RJ: Hospital disaster preparedness in Los Angeles County. Acad Emerg Med. 2006, 13: 1198-203.CrossRefPubMed

17.

Koenig Kl, Cone DC, Burstein JL, Camargo CA: Surging to the right standard of care. Acad Emerg Med. 2006, 13: 195-8. 10.1111/j.1553-2712.2006.tb01673.x.CrossRefPubMed

18.

Derlet WR, Richards JR, Kravitz RL: Frequent Overcrowding in U.S. Emergency Departments. Acad Emerg Med. 2001, 8: 151-553. 10.1111/j.1553-2712.2001.tb01280.x.CrossRefPubMed

19.

Sprivulis PC, Da Silva JA, Jcobs IG, Frazer ARL, Jelinek GA: The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. MJA. 2006, 184: 208-12.PubMed

20.

Chalfin DB, Trzeciak S, Likourezos A, Baumann BM, Dellinger RP: Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Crit Care Med. 2007, 35: 1477-83. 10.1097/01.CCM.0000266585.74905.5A.CrossRefPubMed

21.

Trzeciak S, Rivers EP: Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J. 2003, 20: 402-5. 10.1136/emj.20.5.402.PubMedCentralCrossRefPubMed

22.

Pham JC, Patel R, Millin MG, Kirsch TD, Chanmugam A: The Effects of Ambulance Diversion: A Comprehensive Review. Acad Emerg Med. 2006, 13: 1220-27.CrossRefPubMed

23.

Falvo T, Grove L, Stachura RS, Zirkin W: The Financial Impact of Ambulance Diversions and Patient Elopements. Acad Emerg Med. 2007, 14: 58-62.CrossRefPubMed

24.

Cherry RA, Trainer M: The Current Crisis in Emergency Care and the Impact on Disaster Preparedness. BMC Emerg Med. 2008, 8: 7-10.1186/1471-227X-8-7.PubMedCentralCrossRefPubMed

Title: Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations
Authors: Amir Khorram-Manesh
Annika Hedelin
Per Örtenwall
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2009
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/1757-7241-17-26

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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