TY - JOUR T1 - How safe are paediatric emergency departments? A national prospective cohort study JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 806 LP - 817 DO - 10.1136/bmjqs-2021-014608 VL - 31 IS - 11 AU - Amy C Plint AU - Amanda S Newton AU - Antonia Stang AU - Zach Cantor AU - Lamia Hayawi AU - Nick Barrowman AU - Kathy Boutis AU - Serge Gouin AU - Quynh Doan AU - Andrew Dixon AU - Robert Porter AU - Gary Joubert AU - Scott Sawyer AU - Tyrus Crawford AU - Jocelyn Gravel AU - Maala Bhatt AU - Patrick Weldon AU - Kelly Millar AU - Sandy Tse AU - Gina Neto AU - Simran Grewal AU - Melissa Chan AU - Kevin Chan AU - Grant Yung AU - Jennifer Kilgar AU - Tim Lynch AU - Mary Aglipay AU - Dale Dalgleish AU - Ken Farion AU - Terry P Klassen AU - David W Johnson AU - Lisa A Calder A2 - , Y1 - 2022/11/01 UR - http://qualitysafety.bmj.com/content/31/11/806.abstract N2 - Background Despite the high number of children treated in emergency departments, patient safety risks in this setting are not well quantified. Our objective was to estimate the risk and type of adverse events, as well as their preventability and severity, for children treated in a paediatric emergency department.Methods Our prospective, multicentre cohort study enrolled children presenting for care during one of 168 8-hour study shifts across nine paediatric emergency departments. Our primary outcome was an adverse event within 21 days of enrolment which was related to care provided at the enrolment visit. We identified ‘flagged outcomes’ (such as hospital visits, worsening symptoms) through structured telephone interviews with patients and families over the 21 days following enrolment. We screened admitted patients’ health records with a validated trigger tool. For patients with flags or triggers, three reviewers independently determined whether an adverse event occurred.Results We enrolled 6376 children; 6015 (94%) had follow-up data. Enrolled children had a median age of 4.3 years (IQR 1.6–9.8 years). One hundred and seventy-nine children (3.0%, 95% CI 2.6% to 3.5%) had at least one adverse event. There were 187 adverse events in total; 143 (76.5%, 95% CI 68.9% to 82.7%) were deemed preventable. Management (n=98, 52.4%) and diagnostic issues (n=36, 19.3%) were the most common types of adverse events. Seventy-nine (42.2%) events resulted in a return emergency department visit; 24 (12.8%) resulted in hospital admission; and 3 (1.6%) resulted in transfer to a critical care unit.Conclusion In this large-scale study, 1 in 33 children treated in a paediatric emergency department experienced an adverse event related to the care they received there. The majority of events were preventable; most were related to management and diagnostic issues. Specific patient populations were at higher risk of adverse events. We identify opportunities for improvement in care.All data relevant to the study are included in the article or uploaded as supplementary information. ER -