Enhancing Patient Safety in the Emergency Care of Poisoned Patients: A Participatory Systems Approach

BACKGROUND: Poisoning is a leading cause of injury-related mortality globally, with emergency departments (EDs) playing a critical role in managing these cases. However, treating poisoned patients in EDs presents unique challenges, including variations in clinical presentations, delays in toxicology testing, and communication breakdowns among healthcare professionals. METHODS: This study aimed to develop practical guidance for managing poisoned patients in EDs by engaging multidisciplinary stakeholders using a participatory systems design approach. Structured brainstorming sessions were conducted with 38 healthcare professionals, including toxicologists, emergency nurses, and physicians, organized into six multidisciplinary teams. The Improvement Canvas, developed at the Cambridge Engineering Design Centre, was used to guide participants in identifying key challenges, mapping system dynamics, defining core problems, and proposing targeted solutions. The guidance was refined through multiple iterations and shared with representatives from the Department of Health, Abu Dhabi, for feedback. Additionally, process maps were created to facilitate the implementation of recommendations across regional hospitals. RESULTS: Participants identified several critical areas for improvement, including standardized workflows for triage, resuscitation, and toxicology testing; enhanced mental health support; and improved interdepartmental communication. The resulting framework emphasizes continuous monitoring, real-time information sharing, and cross-functional collaboration among healthcare teams. Feedback from the Department of Health validated the practical relevance and feasibility of the proposed strategies. CONCLUSION: By integrating frontline expertise and systems thinking, this study delivers evidence-based recommendations to standardize care and enhance patient safety in emergency settings. The developed framework supports streamlined emergency care processes by fostering effective teamwork and incorporating perspectives from mental health and toxicology. Implementing these strategies can improve care efficiency and ensure high-quality outcomes for poisoned patients in EDs.