EMERGENCY DEPARTMENT

emergency department

whAT are the main risks?and how can we prevent them?

• located on ground floor
• direct acess patient and ambulance
• adequately staffed with nursing staff + emergency physicians→handle emergencies
• 24/7 availability
• correct and modernised equipment

The emergency departemnt (ED ) of any institution is an entry point for a signifcant number ofpatients to any health care organization.

i 12 hours

+93.5%

from 12 to 24 hours

+4%

over 24 hours

+2,5%

total number of accesses and relative staying time

index

MAIN RISKS

PREVENTION

MAIN "ACTORS" CAUSING RISKs

SYSTEM

PROVIDER

risk of mistakes due to lack of knowlwdge/experience on diseases + skills

time constrains, staff inadequacy, equipment lack/failure

patient complexity: communication barrier, complex medical conditions, cognitive impariment, traditional beliefes, etc

PATIENT

GIORGIA MONTANARO

MARTINA MOLINARI

SONIA DE MORELLI

ASIA FAVERO

team

PREVENTION

• Assign an extensive knowledgable triage nurse
• Minimize verbal orders
• Require that medication orders to be entered electronically.
• Design smooth workflow→improves communication, minimize interruptions and provides for double checks and verbal confirmations before medications are given to the patient.
• Improve documentation→it should be Factual, Accurate, Complete and Timely
• Creation of a standing Risk Committee: can provide focus on risk as an important part of emergency dep. and can also encourage discussions of ongoing risk reduction tools and programs.

• Routine reporting of incidents should be performed as a daily activity and not be underestimated

1. inaccurate triage categorization
2. prolonged waiting time
3. failure in resuscitation managmement
4. failure in communications among care giviers and patients
5. accidental falls
6. improper pain management
7. shortage of health care workers
8. failure in documentation
9. failure in following standard protocol
10. not seeking help when necessary
11. medication errors

MAIN RISKS