Development of an Emergency Department Safety Checklist through a global consensus process
Authors: Rovati Lucrezia , Privitera Daniele , Finch Alexander S. , Litell John M. , Brogan Autumn M. , Tekin Aysun , Castillo Zambrano Claudia , Dong Yue , Gajic Ognjen , Madsen Bo E. ,   for the CERTAIN ED Study Group, Truong Hong Hieu , Nikravangolsefid Nasrin , Ozkan Mahmut Can , Lal Amos , Kilickaya Oguz , Niven Alexander S. , Aaronson Emily , Abdel-Qader Derar H. , Abraham Divya E. , Aguilera Pablo , Ali Saima , Bahreini Maryam , Baniya Anish , Bellolio Fernanda , Bergs Jochen , Bjornsson Hjalti Mar , Bonfanti Alberto , Bravo Jesica , Brown Caitlin S. , Bwambale Basil , Capsoni Nicolò , Casalino Enrique , Chartier Lucas B. , David Sandeep N. , Dawadi Sagun , Di Capua Mirko , Efeoglu Melis , Eidinejad Leila , Eis Doris , Ekelund Ulf , Eken Cenker , Freund Yonathan , Gilbert Brian , Giustivi Davide , Grossman Shamai , Hachimi Idrissi Saïd , Hansen Kim , How Chorng-Kuang , Hruska Katrin , Khan Aamir Ghafoor , Laugesen Henrik , Laugsand Lars Erik , Kule Lawrence , Huong Le Thi Thanh , Lerga Mate , Macias Maroto Marta , Mavrinac Nataša , Menacho Antelo Walter , Aksu Nalan M. , Mileta Tatjana , Mirkarimi Talayeh , Mkanyu Victor , Mnape Neema , Mufarrij Afif , Elgasim Muhammed Elhady Muhammed , Adam Visnja Nesek , Hang Tran Ngoc Thuy , Ninh Nguyen Xuan , Nouri Seyedeh Zahra , Ouchi Kei , Patibandla Sowjanya , Ngoc Pham Tien , Prkačin Ingrid , Redfern Emma , Rendón Morales Alejandro-Antonio , Scaglioni Roberta , Scholten Lindy , Scott Belinda , Shahryarpour Nima , Silanda Optatus , Silva Lucas , Sim Tiong Beng , Slankamenac Ksenija , Sonis Jonathan , Sorić Maša , Sun Yuqiang , Tri Nguyen Thai , Quoc Tran Viet , Tunceri Salim Kemal , Turner Joseph , Vrablik Marie C. , Wali Mohamed , Yin Xiaoxv , Zafar Sana , Zakayo Abedi S. , Zhou Jian-cang , Delalic Didi , Anchise Sveva , Colombo Marta , Bettina Marco , Ciceri Laura , Fazzini Fausto , Guerrieri Rossella , Tombini Valeria , Geraneo Annalisa , Mazzone Annamaria , Alario Cristina , Bologna Elisa , Rocca Eugenia , Parravicini Giorgio , Li Veli Greta , Paduanella Ilaria , Sanfilippo Marianna , Coppola Matteo , Rossini Michela , Saronni Simone 
Published: October 2024

Emergency departments (EDs) are at high risk for medical errors. Checklist implementation programs have been associated with improved patient outcomes in other high-risk clinical settings and when used to address specific aspects of ED care. The aim of this study was to develop an ED Safety Checklist with broad applicability across different international ED settings. A three-round modified Delphi consensus process was conducted with a multidisciplinary and multinational panel of experts in emergency medicine and patient safety. Initial checklist items were identified through a systematic review of the literature. Each item was evaluated for inclusion in the final checklist during two rounds of web-based surveys and an online consensus meeting. Agreement for inclusion was defined a priori with a threshold of 80% combined agreement. Eighty panel members from 34 countries across all seven world regions participated in the study, with comparable representation from low- and middle-income and high-income countries. The final checklist contains 86 items divided into: (1) a general ED Safety Checklist focused on diagnostic evaluation, patient reassessment, and disposition and (2) five domain-specific ED Safety Checklists focused on handoff, invasive procedures, triage, treatment prescription, and treatment administration. The checklist includes key clinical tasks to prevent medical errors, as well as items to improve communication among ED team members and with patients and their families. This novel ED Safety Checklist defines the essential elements of high-quality ED care and has the potential to ensure their consistent implementation worldwide.