Identification of Factors Affecting Patient Safety in the Emergency Department: A Retrospective Study

Abstract

Introduction: Emergency Departments (EDs) have been described as complex, dynamic and at high risk for medical errors. Factors affecting the risk of medical error in the ED are related to communication, triage and medication management and upto 3% of all medical errors in hospitals take place in the ED. Aim: To identify the factors affecting patients’ safety in the EDs of two major hospitals in Taif city based on Occurrence Variance Reporting (OVR). Materials and Methods: The present study was a cross-sectional retrospective study which was conducted from January 2018 to October 2020 at King Abdul-Aziz Specialist Hospital (KAASH) and from October 2018 to October 2020 at King Faisal Medical Complex (KFMC) in Taif city, Makkah, Saudi Arabia. The OVR data included six variables including category of OVR, name of hospital, year of OVR, type of report, who made the OVR and action taken by the hospitals, and was analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS). Results: This study found that 3,632 OVR reports were collected. Nearly two-thirds of all OVRs were associated with nursing care management issues, followed by identification/document/consent issues (9.4%), medical equipment issues (5.5%), housekeeping issues (0.2%) and laundry service (0.1%) representing the lowest frequency of OVR. Unsafe conditions accounted for 75.17% (2,730) of all OVR reports and only 24.83% (902) were incident reports. Staff nurses reported a majority of reports (89.5%), with 10.5% of OVRs reported by other healthcare workers. The primary actions taken by the hospitals in response to these reports were detection (72.3%) and prevention (17.4%), while only 10.3% was corrected. Conclusion: Patient safety is the primary challenge faced by healthcare providers at hospitals. Thus, OVR is a very important tool in order to avoid errors and limit harms ensuring healthcare quality and safety delivery.

Keywords

• medical error
• occurrence variance reporting
• risk