Critical Care Helicopter Overtriage: A Failure Mode and Effects Analysis.

Title

Critical Care Helicopter Overtriage: A Failure Mode and Effects Analysis.

Creator

Grabowski RL; McNett M; Ackerman MH; Schubert C; Mion LC

Publisher

Air Medical Journal

Date

2019
2019-12

Description

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.

Subject

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

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

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Pages

408-420

Issue

6

Volume

38

ISSN

1532-6497 1067-991X

Update Year & Number

Hospital List

Citation

Grabowski RL; McNett M; Ackerman MH; Schubert C; Mion LC, “Critical Care Helicopter Overtriage: A Failure Mode and Effects Analysis.,” NEOMED Bibliography Database, accessed December 5, 2021, https://neomed.omeka.net/items/show/11457.

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