title: Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations.
abstract: BACKGROUND
  A hospital's capacity and preparedness is one of the important parts of disaster planning. Hospital-related incidents, a new phenomenon in Swedish healthcare, may lead to ambulance diversions, increased waiting time at emergency departments and treatment delay along with deterioration of disaster management and surge capacity. We aimed to identify the causes and impacts of hospital-related incidents in Region Västra Götaland (western region of Sweden).
  
  
  METHODS
  The regional registry at the Prehospital and Disaster Medicine Center was reviewed (2006-2008). The number of hospital-related incidents and its causes were analyzed.
  
  
  RESULTS
  There were an increasing number of hospital-related incidents mainly caused by emergency department's overcrowdings, the lack of beds at ordinary wards and/or intensive care units and technical problems at the radiology departments. These incidents resulted in ambulance diversions and reduced the prehospital capacity as well as endangering the patient safety.
  
  
  CONCLUSIONS
  Besides emergency department overcrowdings, ambulance diversions, endangering patient s safety and increasing risk for in-hospital mortality, hospital-related incidents reduces and limits the regional preparedness by minimizing the surge capacity. In order to prevent a future irreversible disaster, this problem should be avoided and addressed properly by further regional studies.
authors.affiliation: Prehospital and Disaster Medicine Centre, Gothenburg, Sweden. amir.khorram-manesh@surgery.gu.se
authors.forename: Amir
authors.initials: A
authors.lastname: Khorram-Manesh
authors.forename: Annika
authors.initials: A
authors.lastname: Hedelin
authors.forename: Per
authors.initials: P
authors.lastname: Ortenwall
mesh_terms: D003441:Crowding; D004189:Disaster Planning; D017598:Efficiency, Organizational; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D012042:Registries; D013548:Sweden