Factors that lead to emergency department overcrowdings, ambulance diversions and other incidents that endanger patient safety have been revealed. A new study has shown that reductions in the number of hospital beds and downsizing or closure of emergency departments may create a dangerous loss of 'surge capacity'.
Amir Khorram-Manesh, from the Prehospital and Disaster Medicine Centre, Gothenburg, Sweden, worked with Annika Hedelin and Per Örtenwall to study all data concerning 'hospital-related incidents' in Sweden's Region Västra Götaland between January 2006 and December 2008. He said, "Disasters seldom occur, but if they strike, a fast and effective response from healthcare services is expected. The incidents we document, where emergency hospitals, for different reasons, could not operate at their normal capacity are a matter of concern for patient safety as well as disaster response preparedness".
The researchers found increasing numbers of 'incidents' over the three years studied. Bed shortages in intensive care and ordinary wards were the most common, followed by technical dysfunctions in the radiology department. They blame cost-cutting reductions in the size and staffing of emergency departments and increased pressure to treat people on an out-patient basis for the rise. Khorram-Manesh said, "Although these measures seem to be logical steps taken to improve healthcare effectiveness and reduce costs, they also, in a negative way, affect the surge capacity of a hospital".
- Amir Khorram-Manesh, Annika Hedelin and Per Örtenwall. Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, (in press)
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