Reducing Hospital Mistakes by Overhauling the ER

An estimated 124 million people visit a hospital emergency room every year and unfortunately it is the place where you are most likely to encounter a medial error. An unfamiliarity with the patient, a lack of communication between doctors and nurses, no medical background on abnormal vital signs, a failure to access timely radiology or lab reports all cause mistakes.

Half of all medical malpractice claims against emergency rooms occur because someone was misdiagnosed and sent home too early like the person complaining of indigestion who was really having a heart attack. The Wall Street Journal reports that because ER errors cost hospitals about $1 billion in claims in 2009, insurers are insisting on tightening standards to keep patients safer and to reduce the cost of errors.

What can be done? According to the insurer Crisco/RMF, which is working with 16 hospitals to improve outcomes:

  • The Huddle: Doctors and nurses confer to make sure nothing is overlooked upon arrival in the ER and before a discharge. Poor doctor-nurse communication often leads to mistakes.
  • Triaging Patients: Dividing the ER into pediatrics, obstetrics and psychiatry separate areas.
  • Don’t Assume: That patients under the age of 55 are not having a heart attack. Insurer CNA Financial suggest everyone who comes in with chest pain be admitted to the hospital because the rate of death when heart attack is missed is double those who are admitted. Strokes are often missed too because of the younger age of the patient.
  • Time Out: Allow for a time before the patient is sent home to check vital signs and see if symptoms are getting worse.
  • Intervene Quicker: Especially among those patients who have abnormalities in five vital signs including an elevated blood pressure or heart rate.

For patients – bring as much information about your medical history as is possible to the ER along with information about your primary care doctor. Be prepared to share that information with personnel on the next ER shift. Don’t assume they have shared it among themselves.