Contributing factors to errors in Swedish emergency departments

• We analysed a total of 64 (5%) cases of emergency department errors.
• Factors contributing to errors were multifactorial.
• Errors included organizational and teamwork failure in which human error was largely involved.
• Human behaviour should be considered when improving patient safety in complex organizational systems.

ObjectiveThe Emergency Department (ED) is a complex and dynamic environment, often resulting in a somewhat uncontrolled and unpredictable workload. Contributing factors to errors in health care and in the ED are largely related to communication breakdowns. Moreover, the ED work environment is predisposed to multitasking, overcrowding and interruptions. These factors are assumed to have a negative impact on patient safety. Reported errors from care providers are mainly related to diagnostic procedures in Swedish EDs. However, there is a lack of knowledge and national oversight regarding contributing factors. The aim of this study was therefore to describe contributing factors in regards to errors occurring in Swedish EDs.MethodDescriptive design based on registry data from the Lex Maria database of the Swedish National Board of Health and Welfare.ResultsThe results indicate that factors contributing to errors in Swedish EDs are multifactorial in nature. The most common contributing factor was human error followed by factors in the local ED environment and teamwork failure.ConclusionFactors contributing to ED errors were multifactorial and included both organizational and teamwork failure in which human error was implicated. To reduce errors, further research is needed to develop methods that disclose latent working conditions such as high workload and interruptions. Patient safety research needs to include understanding of human behaviour in complex organizational systems and the impact of working conditions on patient safety and quality of care.