title: Contributing factors to errors in Swedish emergency departments.
abstract: OBJECTIVE
  The 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.
  
  
  METHODS
  Descriptive design based on registry data from the Lex Maria database of the Swedish National Board of Health and Welfare.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Factors 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.
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, Solna, Sweden; Department of Emergency Medicine, Falun Hospital, Falun, Sweden. Electronic address: ann-sofie.kallberg@ltdalarna.se.
authors.forename: Ann-Sofie
authors.initials: AS
authors.lastname: Källberg
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, Solna, Sweden; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
authors.forename: Katarina E
authors.initials: KE
authors.lastname: Göransson
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Florin
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, Solna, Sweden; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Östergren
authors.affiliation: School of Biomedical Informatics, University of Texas, Houston, Texas, USA.
authors.forename: Juliana J
authors.initials: JJ
authors.lastname: Brixey
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Ehrenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D061214:Patient Safety / Q000592:standards*; D013548:Sweden; D016526:Workload
keywords: Emergency department; Patient safety