Aim: Develop a proactive system to detect sub-optimal care, near misses and harm in Emergency Medicine The main outcome measure used in EM is the achievement of the 4 hour target where 98% of patients should be admitted / discharged within 4 hours of registration. This should encourage good practice so that patients are provided with efficient and effective care. It is important to ensure that the pressure of a time based target does not compromise the quality of care delivered. It is important therefore to develop a tool to detect the incidence of sub-optimal care and harm.
