Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan 29;6(1):e009837.
doi: 10.1136/bmjopen-2015-009837.

Improving the governance of patient safety in emergency care: a systematic review of interventions

Gijs Hesselink  1 , Sivera Berben  2 , Thimpe Beune  3 , Lisette Schoonhoven  4
Affiliations

Improving the governance of patient safety in emergency care: a systematic review of interventions

Gijs Hesselink et al. BMJ Open. .

Abstract

Objectives: To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility.

Design: A systematic review of the literature.

Methods: PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews and PsychInfo were searched for studies published between January 1990 and July 2014. We included studies evaluating interventions relevant for higher management to oversee and manage patient safety, in prehospital emergency medical service (EMS) organisations and hospital-based emergency departments (EDs). Two reviewers independently selected candidate studies, extracted data and assessed study quality. Studies were categorised according to study quality, setting, sample, intervention characteristics and findings.

Results: Of the 18 included studies, 13 (72%) were non-experimental. Nine studies (50%) reported data on the reliability and/or validity of the intervention. Eight studies (44%) reported on the feasibility of the intervention. Only 4 studies (22%) reported statistically significant effects. The use of a simulation-based training programme and well-designed incident reporting systems led to a statistically significant improvement of safety knowledge and attitudes by ED staff and an increase of incident reports within EDs, respectively.

Conclusions: Characteristics of the interventions included in this review (eg, anonymous incident reporting and validation of incident reports by an independent party) could provide useful input for the design of an effective tool to govern patient safety in EMS organisations and EDs. However, executives cannot rely on a robust set of evidence-based and feasible tools to govern patient safety within their emergency care organisation and in the chain of emergency care. Established strategies from other high-risk sectors need to be evaluated in emergency care settings, using an experimental design with valid outcome measures to strengthen the evidence base.

Keywords: ACCIDENT & EMERGENCY MEDICINE; HEALTH SERVICES ADMINISTRATION & MANAGEMENT.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart of the study selection and review process.
See this image and copyright information in PMC

References

    1. Callender AN, Hastings DA, Hemsley MC et al. Corporate Responsibility and Health Care Quality: A Resource for Health Care Boards of Directors 2007. https://oig.hhs.gov/fraud/docs/complianceguidance/CorporateResponsibilit... (accessed 23 Feb 2015).
    1. Goeschel C, Wachter R, Pronovost P. Responsibility for quality improvement and patient safety: hospital boards and medical staff leadership challenges. Chest 2010;138:171–8. 10.1378/chest.09-2051 - DOI - PubMed
    1. Millar R, Mannion R, Freeman T et al. Hospital board oversight of quality and patient safety: a narrative review and synthesis of recent empirical research. Milbank Q 2013;91:738–70. 10.1111/1468-0009.12032 - DOI - PMC - PubMed
    1. Patterson PD, Arnold RM, Abebe K et al. Variation in emergency medical technician partner familiarity. Health Serv Res 2011;46:1319–31. 10.1111/j.1475-6773.2011.01241.x - DOI - PMC - PubMed
    1. Owen C, Hemmings T, Brown T. Lost in translation: maximizing handover effectiveness between paramedics and receiving staff in the emergency department. Emerg Med Australas 2009;21:102–7. 10.1111/j.1742-6723.2009.01168.x - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources