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A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar
Introduction Adverse Events (AEs) in Helicopter Emergency Medical Services (HEMS) remains poorly reported, despite the potential for harm to occur. The Trigger Tool (TT) represents a novel approach to AE detection in healthcare. The aim of this study was to retrospectively describe the frequency of...
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| Format: | Thesis |
| Language: | English |
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Division of Emergency Medicine
2022
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| _version_ | 1867613277596418048 |
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| access_status_str | Open Access |
| author | Heuer, Calvin |
| author2 | Stassen, Willem |
| author_browse | Heuer, Calvin Stassen, Willem |
| author_facet | Stassen, Willem Heuer, Calvin |
| author_sort | Heuer, Calvin |
| collection | Thesis |
| description | Introduction Adverse Events (AEs) in Helicopter Emergency Medical Services (HEMS) remains poorly reported, despite the potential for harm to occur. The Trigger Tool (TT) represents a novel approach to AE detection in healthcare. The aim of this study was to retrospectively describe the frequency of AEs and their Proximal Causes (PCs) in Qatar HEMS. Methods Using the Pittsburgh Adverse Event Tool (PittAETool) to identify AEs in HEMS, we retrospectively analyzed 804 records within an existing AE TT database (21-month period). We calculated outcome measures for Triggers, AEs, and Harm per 100 patient encounters, plotted measures on Statistical Process Control (SPC) charts, and conducted a multivariate analysis to report harm associations. Results We identified 883 Triggers in 536 patients, with a rate of 1.1 Triggers per Patient Encounter, where 81.2% had Documentation Errors (n=436). An AE and Harm rate of 27.7% and 3.5% respectively was realized. The leading PC was Actions by HEMS Crew (81.6%; n=182). The majority of harm (57.1%) stemmed from the Intervention and Medication triggers (n=16), where Deviation from Standard of Care was common (37.9%; n=11). Age and diagnosis adjusted odds was significant in the Patient Condition (6.50; 95% CI, 1.71-24.67; P= 0.01) and Interventional (11.85; 95% CI, 1.36-102.92; P= 0.03) trigger groupings, while age and diagnosis had no effect on Harm. Conclusion The TT methodology is a robust, reliable, and valid means of AE detection in the HEMS domain. Whilst an AE rate of 27.7% is high, more research is required to understand prehospital clinical decision-making and reasons for guideline deviance. Furthermore, focused quality improvement initiatives to reduce AEs and Documentation errors should also be addressed in future research. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/35806 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:35.758Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Division of Emergency Medicine |
| publisherStr | Division of Emergency Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/35806 A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar Heuer, Calvin Stassen, Willem Howard, Ian Emergency Medicine Introduction Adverse Events (AEs) in Helicopter Emergency Medical Services (HEMS) remains poorly reported, despite the potential for harm to occur. The Trigger Tool (TT) represents a novel approach to AE detection in healthcare. The aim of this study was to retrospectively describe the frequency of AEs and their Proximal Causes (PCs) in Qatar HEMS. Methods Using the Pittsburgh Adverse Event Tool (PittAETool) to identify AEs in HEMS, we retrospectively analyzed 804 records within an existing AE TT database (21-month period). We calculated outcome measures for Triggers, AEs, and Harm per 100 patient encounters, plotted measures on Statistical Process Control (SPC) charts, and conducted a multivariate analysis to report harm associations. Results We identified 883 Triggers in 536 patients, with a rate of 1.1 Triggers per Patient Encounter, where 81.2% had Documentation Errors (n=436). An AE and Harm rate of 27.7% and 3.5% respectively was realized. The leading PC was Actions by HEMS Crew (81.6%; n=182). The majority of harm (57.1%) stemmed from the Intervention and Medication triggers (n=16), where Deviation from Standard of Care was common (37.9%; n=11). Age and diagnosis adjusted odds was significant in the Patient Condition (6.50; 95% CI, 1.71-24.67; P= 0.01) and Interventional (11.85; 95% CI, 1.36-102.92; P= 0.03) trigger groupings, while age and diagnosis had no effect on Harm. Conclusion The TT methodology is a robust, reliable, and valid means of AE detection in the HEMS domain. Whilst an AE rate of 27.7% is high, more research is required to understand prehospital clinical decision-making and reasons for guideline deviance. Furthermore, focused quality improvement initiatives to reduce AEs and Documentation errors should also be addressed in future research. 2022-02-22T04:19:11Z 2022-02-22T04:19:11Z 2021 2022-02-16T06:12:30Z Master Thesis Masters MPhil http://hdl.handle.net/11427/35806 eng application/pdf Division of Emergency Medicine Faculty of Health Sciences |
| spellingShingle | Emergency Medicine Heuer, Calvin A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar |
| thesis_degree_str | Master's |
| title | A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar |
| title_full | A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar |
| title_fullStr | A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar |
| title_full_unstemmed | A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar |
| title_short | A Trigger-Tool-based Description of Adverse Events in Helicopter Emergency Medical Services in Qatar |
| title_sort | trigger tool based description of adverse events in helicopter emergency medical services in qatar |
| topic | Emergency Medicine |
| url | http://hdl.handle.net/11427/35806 |
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