[Quality management: protocols for reporting in-hospital emergencies. Comparison of two methods].
OBJECTIVE
10-20% of hospitalized patients experience adverse events, becoming clinically relevant in emergency situations (ES). Many studies have confirmed deficits in both organizational and professional aspects of care when responding to acute illness. These may result in a worsening outcome. A detailed reporting of acute intervention is necessary to make possible the detailed analysis of such situations and thus optimize the management of ES. It was the aim oft this study to compare the precision achieved in documenting ES using an in-hospital emergency protocol (IHEP), specifically developed for documentation of ES, with that using a standard anesthesia protocol (SAP), to prove which format would reflect the facts of the ES in better detail.


METHODS
All IHEP documented in hospital emergencies between 2005 and 2007 were retrospectively analysed in order to compare them with ES documented by SAP during the same period of time.


RESULTS
200 protocols (52 IHEP and 146 SAP were included. Due to a lack of adequate structuring the conventional anesthesia protocols reported most details of ES in plain text. In comparison IHEP documentation allowed a more detailed, precise and complete documentation of ES.


CONCLUSIONS
IHEP, designed according to the well known DIVI out-of-hospital emergency protocol, seems to be superior to using an SAP. Using IHEP is practicable and results in well documented data of ES, both medical and legal aspects of documentation are regarded. Retrospective analysis to improve ES performance is quite feasible when using HIP.
Klinik und Poliklinik für Innere Medizin I, Universität Regensburg, Regensburg. Sylvia.Siebig@klinik.uni-regensburg.de
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Reng
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Langgartner
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004282:Documentation / Q000379:methods* / Q000592:standards; D004630:Emergencies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012308:Risk Management / Q000379:methods* / Q000592:standards; D055815:Young Adult