Write improvement project Following SQUIRE

Improvement in Return to ED Safety Measures in KAMC-NGHA)

Introduction:

Emergency department return cases as critical/dead patients is a concern to be measured and valued for any healthcare organization.

Objectives:

This study aimed to reduce the return of critical/dead adult patients to ER within 72 hours in King Abdulaziz Medical City (KAMC) at National Guard Health Affairs (NGHA) in the Kingdom of Saudi Arabia (KSA) and identify the inappropriate discharge of the first visit.

Methodology:

We conducted a multidisciplinary approach started in 2022 to monitor the ED return cases through daily trigger notification within 72 hours. Implement a consultation checklist through the HIS. SMS escalation message to leadership for any sentinel or serious event. Moreover, ensure appropriate discharge by involving subspecialty to physically assess the patient before discharge. Data was captured through the dashboard for 2021 until March 2023

Results:

The events were reduced from 0.13 % in 2021 to 0.08% in 2022-2023.

Conclusion: Continuous monitoring is required by applying daily trigger tools. Analyzing and escalating the return patients to ED in KAMC-NGHA.

Keywords: ED, Emergency Department, HIS, ER, KAMC, NGHA, KSA.

Figure 1: ED Return as Critical/Dead

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