title: The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system.
abstract: BACKGROUND
  The role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives.
  
  
  METHODS
  An ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010.
  
  
  RESULTS
  During the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population.
  
  
  CONCLUSIONS
  Despite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a "learning organization" and improve both efficacy and safety of first aid care.
authors: *Department of Public Health and Community Medicine,University of Verona,Italy.
authors: Alberto
authors: A
authors: Mortaro
authors: †Health Care Trust 20,Verona,Italy.
authors: Diana
authors: D
authors: Pascu
authors: †Health Care Trust 20,Verona,Italy.
authors: Tamara
authors: T
authors: Zerman
authors: †Health Care Trust 20,Verona,Italy.
authors: Enrico
authors: E
authors: Vallaperta
authors: †Health Care Trust 20,Verona,Italy.
authors: Alberto
authors: A
authors: Schönsberg
authors: *Department of Public Health and Community Medicine,University of Verona,Italy.
authors: Stefano
authors: S
authors: Tardivo
authors: *Department of Public Health and Community Medicine,University of Verona,Italy.
authors: Serena
authors: S
authors: Pancheri
authors: *Department of Public Health and Community Medicine,University of Verona,Italy.
authors: Gabriele
authors: G
authors: Romano
authors: *Department of Public Health and Community Medicine,University of Verona,Italy.
authors: Francesca
authors: F
authors: Moretti
mesh_terms: D000328:Adult; D004630:Emergencies / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008503:Medical Staff / Q000458:organization & administration*; D008875:Middle Aged; D009017:Morbidity; D010549:Personal Satisfaction; D012189:Retrospective Studies; D014218:Triage / Q000379:methods*
keywords: incident reporting; patient safety; prehospital emergency care; quality improvement; risk management