Study characteristics
| First author (year) (country) | Design | Setting | Sample | Intervention | Findings | ||
|---|---|---|---|---|---|---|---|
| Effects | Psychometrics | Feasibility | |||||
| Wolff (2002) (Australia)22 | Quasi-experimental (BA) | ED (n=1) | Reviewed patient medical records (n=20 050) | Incident reporting in addition to standardised screening of medical records on AEs | Reduced AEs* | NR | NR |
| Hendrie (2007) (Australia)23 | Non-experimental | ED (n=1) | Patient case histories (n=3332) | AE screening | NR | Inter-rater reliability | Time† |
| Patterson (2012) (USA)35 | Non-experimental | EMS (n=NR) | Patient case reports (n=250) | AE identification and severity rating method | NR | Internal reliability; construct validity | NR |
| Patterson (2014) (USA)37 | Non-experimental | HEMS (n=NR) | Expert clinicians in emergency medicine and HEMS (n=10) | AE identification and severity rating method | NR | Content and face validity | NR |
| Clunas (2009) (Australia)24 | Non-experimental | ED (n=1) | Reviewed patient deaths (n=303) | Audit of all deaths that occurred within 48 h of ED presentation in addition to auditing all deaths that occurred in the ED itself | NR | NR | Usability‡ |
| van Noord (2010) (The Netherlands)25 | Non-experimental | ED (n=31) | Closed and settled claim files (n=47) | Root Cause Analysis using PRISMA method | NR | Inter-rater reliability; face validity | Time† |
| Patterson (2010) (USA)26 | Non-experimental | EMS agencies (n=3) | EMTs and paramedics (n=71) | EMS-SAQ | NR | Internal reliability; construct validity | Response rate‡; user friendliness‡ |
| Patterson (2010) (USA)27 | Non-experimental | EMS agencies (n=61) | Care providers (n=1595) | EMS-SAQ | NR | Inter-rater reliability; face validity | NR |
| Flowerdew (2012) (UK)38 | Non-experimental | ED (n=2) | NR | Observational physician (non-technical) skills assessment | NR | Face and content validity | NR |
| Jaynes (2013) (USA)39 | Non-experimental | EMS (n=NR) | EMS care providers (n=380) | EMS and HEMS working relationship satisfaction questionnaire | NR | Internal reliability; face, content and construct validity | NR |
| Evans (2007) (Australia)28 | Quasi experimental (NEG) | ED (n=4) | ED (n=2) attendances (n=66 669) with intervention vs ED (n=2) attendances (n=78 264) with usual procedure | Incident reporting programme comprising intense staff education, 24/7 reporting options, changes in report management and enhanced feedback | Increased IRs* | NR | NR |
| Zwart (2011) (The Netherlands)29 | Quasi experimental (NEG) | GP OHS (n=3) | GP OHS with intervention (n=1); GP OHS with usual procedure (n=2) | Local incident-reporting vs centralised incident reporting (usual procedure) | Increased IRs; increased IR types | NR | Time‡; costs† |
| Reznek (2014) (USA)30 | Quasi experimental (ITS) | ED (n=1) | IRs (n=314) | Standardised non-punitive peer review of IRs | Increased monthly frequencies of IRs* | NR | NR |
| Schull (2011) (Canada)36 | Non-experimental | ED (n=NR) | Candidate indicators (n=170) | Patient safety indicators | NR | Face validity | Usability‡ |
| Pham (2011) (USA)31 | Non-experimental | ED (n=1) | Patients seen in the ED within 72 h of prior visit (n=6858) and patients not seen in the ED within 72 h (n=211 321) | Patient safety indicator | NR | NR | Usability† |
| Jones (2013) (USA)32 | Non-experimental | ED (n=2) | Care providers (n=60) | Teamwork training on patient safety (TeamSTEPPS) | Positive change in safety culture perception | NR | NR |
| Patterson (2013) (USA)33 | Quasi experimental (ITS) | Paediatric ED (n=1) | Care providers (n=151) | Multidisciplinary simulation-based training | Increased staff safety knowledge*; increased staff safety attitude* | NR | Time‡ |
| Shaw (2006) (USA)34 | Non-experimental | Paediatric ED (n=1) | Staff (n=99) | Unit-based Patient Safety Walk-rounds | Increased IRs; increased hand hygiene compliance | NR | NR |
*Statistical significant effect (p<0.05).
†Negative finding with regard to the feasibility of the intervention.
‡Positive finding with regard to the feasibility of the intervention.
AE, adverse event; BA, before–after; ED, emergency department; EMS, emergency medical services; EMS-SQA, EMS-Safety Attitudes Questionnaire; EMT, emergency medical technician; GP OHS, general practitioner out-of-hours services; HEMS, helicopter EMS; IR, incident report; ITS, interrupted time series; NEG, non-equivalent group; NR, not reported; PRISMA, Prevention and Recovery Information System for Monitoring and Analysis.