Abstract

Objectives: To identify common risk types occurring in emergency departments (EDs). To compare the risks occurring between different emergency departments.

Design: Application of a typology of risks to a database of critical incidents. Comparison of results of applying typology to group of critical incidents collected in a uniform manner in four different EDs.

Setting: EDs in two teaching hospitals and two district general hospitals in the north west of England.

Interventions: Observational study.

Main outcome measures: Types of critical incidents identified. Statistical comparisons between EDs.

Results: 816 critical incidents were classified. Patient assessment omission failures were the commonest type of failure, accounting for 291 (35.6%) of the critical incidents. Level 1 and level 2 failures accounted for 254 (31.1%) of critical incidents. Significant differences (p = 0.009) were shown between EDs when the categories of critical incidents occurring were compared. No significant differences (p = 0.336) were shown between EDs when the levels of severity of critical incidents occurring were compared.

Conclusions: Large numbers of critical incidents with potentially fatal consequences occur. The types of risks differ significantly between different EDs.