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Errors in a busy emergency department
James Fordyce1, Fidela S j Blank, Penelope Pekow
1Department of Emergency Medicine, Baystate Medical Center, Springfield, MA 01199, USA.
Annals of Emergency Medicine
|August 29, 2003
Summary
In a busy emergency department (ED), nearly all errors occurred across various care aspects, with 98% not causing adverse outcomes. System improvements are crucial for reducing these frequent ED errors.
Area of Science:
- Emergency Medicine
- Patient Safety
- Healthcare Quality Improvement
Background:
- Medical errors are a significant concern in healthcare settings.
- Understanding the types and frequency of errors in emergency departments (EDs) is vital for improving patient safety.
Purpose of the Study:
- To prospectively identify and categorize errors occurring in a high-volume academic emergency department.
- To determine the frequency of errors and their association with patient outcomes.
Main Methods:
- A prospective, observational study was conducted in an academic ED with 100,000 annual visits.
- Trained personnel interviewed all ED staff during and after shifts using standardized data sheets.
- Error reports were collected over a 7-day period.
Main Results:
- 346 non-duplicative errors were identified among 1935 patients (18 errors per 100 patients).
- Errors spanned diagnostic studies, administrative procedures, pharmacotherapy, documentation, communication, and environmental factors.
- Older patients and those with higher visit intensity were more likely to be involved in errors; 98% of errors did not result in adverse outcomes.
Conclusions:
- Errors are pervasive across all facets of emergency care.
- The vast majority of identified errors in the ED do not lead to significant adverse patient outcomes.
- System-level changes are necessary to mitigate the occurrence of ED errors.