Frameworks for incident classification in emergency departments
Citation: Murray M, McCarthy S. Review article: A systematic review of emergency department incident classification frameworks. Emergency Medicine Australasia. 2018;30(3):293-308.
Language: Abstract and full text available in EN.
Free to view: No.
Funding sources: Emergency Care Institute at the New South Wales Agency for Clinical Innovation and the Hospital Alliance for Research Collaboration (Australia).
What is this? The provision of care in emergency departments is often complex, and an incident classification might facilitate a better understanding of potential issues and improve quality of care, helping to ensure the resilience of health systems.
In this systematic review, the authors searched for studies of frameworks for incident classification in emergency departments. They restricted their searches to articles published in English and did the search in February 2016. They included 17 articles.
What was found: At the time of this review, frameworks for incident classification in emergency departments varied widely and the authors found no framework to be better than others.
The themes categorised by the review authors included patient, activity, staff, environment, organisation and external factors.
There were four major methods to design the classifications. These used primary incident data, customisation of existing frameworks, incident theory and mapping to emergency department processes and clinical pathways.
Implications: The authors of the review concluded that inconsistencies in the frameworks used, the complex nature of emergency department care and the objectivity of reporting, meant that it would be difficult to develop an ideal classification system. They stated that a more nuanced framework should look into incorporating a greater number of theories, making it better informed and generalised.
Other considerations: The authors of the review did not discuss their findings in the context of issues relating to health equity.
This summary was prepared by Jeremy Scudder, checked by Yasmeen Saeed and Cristián Mansilla, and finalized by Mike Clarke.