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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
PubMed
Summary
This summary is machine-generated.

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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.

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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.