Adverse Events in Patients Transitioning From the Emergency Department to the Inpatient Setting.

Area of Science:

• Healthcare quality and safety
• Patient transition of care
• Medical error analysis

Background:

• Patient safety during care transitions is a critical concern.
• The emergency department (ED) to inpatient setting is a vulnerable period for adverse events (AEs).

Purpose of the Study:

• To determine the incidence and types of AEs during ED to inpatient transitions.
• To identify risk factors associated with AEs in this patient population.
• To assess the preventability and ameliorability of identified AEs.

Main Methods:

• Prospective cohort study conducted in two urban academic hospitals.
• Recruitment of 81 patients at risk for AEs transitioning from the ED.
• Structured interviews and blinded physician adjudication for AE assessment.

Main Results:

• Over 22% of patients experienced AEs during the ED to inpatient transition.
• Adverse drug events (42%) were the most frequent AE type, followed by management (38%) and diagnostic errors (21%).
• A prolonged ED length of stay was a significant risk factor for AEs (aOR = 1.99).

Conclusions:

• Adverse events are frequent and often preventable during the ED to inpatient transition.
• Further research is necessary to elucidate underlying causes and develop targeted interventions.
• Reducing ED length of stay may mitigate the risk of AEs during this critical care phase.