Department of EmergencyMedicine, Geisinger Health System, Danville, Pennsylvania 17822-2005, USA.
Prehosp Emerg Care. 2012 Jan-Mar;16(1):36-42. doi: 10.3109/10903127.2011.626105.
Patient and provider safety is paramount in all aspects of emergency medical services (EMS) systems. The leaders, administrators, and policymakers of these systems must have an understanding of situations that present potential for harm to patients or providers.
This study analyzed reports to a statewide EMS safety event reporting system with the purpose of categorizing the types of incidents reported and identifying opportunities to prevent future safety events.
This statewide EMS safety incident reporting system is a Web-based system to which any individual can anonymously report any event or situation perceived to impact safety. We reviewed all reports between the system's inception in 2003 through August 2010. A stipulation of the system is that any entry containing information that identifies an EMS provider, agency, or patient will be deleted and thus not included in the analysis. Each event report included the description of the event, the relationship of the reporter, and the year in which the event occurred. Each entry was placed into a category that best represents the situation described.
A total of 415 reports were received during the study period, and 186 reports were excluded-163 (39%) excluded by the state because of identifiable information and 23 (6%) excluded by the authors because of nonsensical description. Within the remaining 229 reports, there were 237 distinct safety events. These events were classified as actions/behavior (32%), vehicle/transportation (16%), staffing or ambulance availability (13%), communications (8%), medical equipment (9%), multiple patients/agencies/units and level-of-care issues (7%), medical procedure (6%), medication (5%), accident scene management/scene safety (3%), and protocol issues (1%). EMS providers directly involved in the event represented the largest reporting group (33%). We also provide examples of statewide system and policy changes that were made in direct response to these reports.
This EMS safety incident reporting system identified situations that occurred in many categories of EMS care. These potential dangers represent opportunity to assess, and ultimately change, policy and procedures to reduce potential safety events and medical errors and improve overall safety. A substantial number of cases were excluded to maintain the promise of anonymity within the system.
在急救医疗服务（EMS）系统的各个方面，患者和医护人员的安全都是至关重要的。这些系统的领导者、管理者和决策者必须了解可能对患者或医护人员造成伤害的情况。
本研究分析了向全州 EMS 安全事件报告系统提交的报告，旨在对报告的事件类型进行分类，并确定预防未来安全事件的机会。
本全州 EMS 安全事件报告系统是一个基于网络的系统，任何人都可以匿名报告任何被认为会影响安全的事件或情况。我们回顾了该系统 2003 年成立至 2010 年 8 月期间收到的所有报告。该系统的一个规定是，任何包含可识别 EMS 提供者、机构或患者信息的条目都将被删除，因此不会包含在分析中。每个事件报告都包含事件描述、报告人的关系以及事件发生的年份。每个条目都被归入最能代表所描述情况的类别。
在研究期间共收到 415 份报告，其中 186 份被排除在外-163 份（39%）因可识别信息被州政府排除，23 份（6%）因描述不合理被作者排除。在剩余的 229 份报告中，有 237 个不同的安全事件。这些事件被分为行动/行为（32%）、车辆/运输（16%）、人员配备或救护车可用性（13%）、通信（8%）、医疗设备（9%）、多个患者/机构/单位和护理级别问题（7%）、医疗程序（6%）、药物（5%）、事故现场管理/现场安全（3%）和协议问题（1%）。直接参与事件的 EMS 提供者是最大的报告群体（33%）。我们还提供了全州系统和政策变更的例子，这些变更直接针对这些报告做出。
本 EMS 安全事件报告系统确定了发生在 EMS 护理多个类别的情况。这些潜在危险代表了评估的机会，并最终改变政策和程序，以减少潜在的安全事件和医疗失误，提高整体安全性。为了在系统中保持匿名的承诺，大量案例被排除在外。
