Adverse events in prehospital emergency care: a trigger tool study

Area of Science:

• Prehospital Emergency Medicine
• Patient Safety Research
• Healthcare Quality Improvement

Background:

• Prehospital emergency care is a complex, high-risk activity with limited patient safety research.
• Investigating adverse events (AEs) is crucial for enhancing patient safety in prehospital settings.

Purpose of the Study:

• To determine the incidence of adverse events (AEs) in prehospital emergency care.
• To identify factors contributing to AEs in prehospital settings.

Main Methods:

• Retrospective study design analyzing 1080 prehospital medical records from three Swedish organizations.
• Utilized 11 screening criteria to identify AEs in randomly selected records over one year.

Main Results:

• Identified 46 AEs in 4.3% of records; 4.0% were potential for harm and 0.3% resulted in harm.
• Higher AE risk (16.5%) observed in patients with life-threatening conditions.
• Common contributing factors included deviations from standard care and incomplete documentation by emergency medical service (EMS) crews.

Conclusions:

• Swedish prehospital care experiences 4.3 AEs per 100 missions, primarily from care deviations and poor documentation.
• Patients with life-threatening conditions face an elevated risk of AEs.
• Most identified AEs were preventable, highlighting opportunities for safety improvements.