1
40
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Text
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URL Address
<a href="http://doi.org/10.1016/j.amj.2019.07.012" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.amj.2019.07.012</a>
Pages
408-420
Issue
6
Volume
38
ISSN
1532-6497 1067-991X
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<a href="http://neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.amj.2019.07.012" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.amj.2019.07.012</a>
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Update Year & Number
Hospital List
Dublin Core
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Title
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Critical Care Helicopter Overtriage: A Failure Mode and Effects Analysis.
Publisher
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Air Medical Journal
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-12
Subject
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Aged; Humans; Male; Adult; Female; Aged 80 and over; Middle Aged; Infant; Adolescent; Child; Emergency Medical Services; Young Adult; Child Preschool; Quality Improvement; Aircraft; Healthcare Failure Mode and Effect Analysis/methods; Triage/standards; Air Ambulances
Creator
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Grabowski RL; McNett M; Ackerman MH; Schubert C; Mion LC
Description
An account of the resource
OBJECTIVE: Overtriage (OT) of helicopter emergency medical services (HEMS) poses significant burden to multiple stakeholders. The project aims were to identify the following: 1) associated factors, 2) downstream effects, and 3) focus areas for change. METHODS: We undertook a failure mode and effects analysis (FMEA) to evaluate our HEMS interfacility transport process. Data were collected from organizational finances and 3 key stakeholder groups: 1) interfacility patients transferred by HEMS in 2017 who were discharged from the receiving facility within 24 hours (n = 149), 2) flight registered nurses (n = 19), and 3) referring emergency medicine providers (EMPs) (n = 30) from the top HEMS users of 2017. The completed FMEA identified failure modes, the frequency and severity of effects, and unique risk profile numbers (RPNs). RESULTS: Twelve failure modes were identified with 30 potential causes. Leading failure modes included inappropriate HEMS requests by EMPs (RPN = 343), inappropriate activation by EMS for interfacility transport (RPN = 343), and minimizing patient/family involvement in decision making (RPN = 315). Significant burdens to organizational finances and flight registered nurse satisfaction were identified. CONCLUSION: Associated factors for interfacility HEMS OT, downstream effects, and areas for change were identified. EMP and emergency medical services practices, HEMS processes, and shared decision making may affect regional OT rates.
Identifier
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<a href="http://doi.org/10.1016/j.amj.2019.07.012" target="_blank" rel="noreferrer noopener">10.1016/j.amj.2019.07.012</a>
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Format
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journalArticle
2019
Ackerman MH
Adolescent
Adult
Aged
Aged 80 and over
Air Ambulances
Air medical journal
Aircraft
Child
Child Preschool
Emergency Medical Services
Female
Grabowski RL
Healthcare Failure Mode and Effect Analysis/methods
Hospital List
Humans
Infant
journalArticle
Male
McNett M
Middle Aged
Mion LC
Quality Improvement
Schubert C
Triage/standards
Young Adult