This report summarises the 2014-15 implementation of the Emergency Medicine Events Register (EMER), an emergency medicine-specific incident reporting system, across Australia and New Zealand. The aim of the implementation was to enable the provision of EMER to all Australasian College for Emergency Medicine (ACEM) members, through developing the database and website, wide recruiting of site champions, ‘burst reporting’ (targeting specific incident types), classification of incidents and feed back to the profession.

The 2014-15 implementation:

  • Updated the website’s software platform and added content about the implementation, patient safety resources and EMER publications and presentations to the website
  • Expanded the EMER steering group to a 15 person committee that met monthly
  • Recruited 23 additional site champions (from 26 hospitals) updated through monthly newsletters
  • Published and presented 11 outputs for national and international conferences and national journals; two further publications are in preparation
  • Led to 108 incidents reported into the EMER
  • Attracted significantly more visitors to the EMER website, with a peak at the end of the implementation, coinciding with international presentations, project publicity and the conclusion of the burst reporting phase. Overall there were 2585 EMER users (5.4 per day) and 3202 sessions (6.6 per day).
  • Provided an analysis of the incident characteristics of all 191 incidents in the database, describing, for example, patient demographics, triage score, medical specialties involved, and system safety variables such as the phase of ED care in which the incident was initiated and detected.
  • Demonstrated international interest in EMER, as more than 50% of users were based outside of Australian and New Zealand.

Although many of the above points reflect a successful implementation, a number of issues are discussed in the report that suggest a low uptake of EMER by ED doctors. In particular, (i) the low absolute rate of reporting incidents, (ii) the lack of success of the ‘burst reporting’ phase in generating airways incidents, and (iii) the low uptake (in terms of site champions, EMER usage and incident reports) from New Zealand are discussed within. For continued success of EMER, these issues will require careful consideration by key stakeholders including ACEM and its Fellows.