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Human Errors Common Cause of Adverse Events in the ER

Human error, often involving poor communication between departments, appears to be the most common cause of errors that occur in hospital emergency departments.

Marleen Smits, from The Netherlands Institute for Health Services Research in Utrecht (The Netherlands), and colleagues, conducted an  analysis of unintended events reported by emergency departments at 10 Dutch hospitals.  They found that more than half the errors had “consequences for the patient”; for 45% that consequence was inconvenience, such as a prolonged waiting time.  In addition, in 30% of cases, the patient received suboptimal care (such as delay in the initiation of treatment).  Additionally, the team found that 44% of errors “were known to occur during daytime hours and 34% during evening and night.”  The proximate stage at which 36% of errors occurred was during the medical examination and/or diagnostic testing — often because of miscommunication between emergency department staff and staff in other departments. Noting that “25% of errors [were] related to cooperation with other departments” and that “most root causes were human (60%),” the researchers urge “direct interventions on the collaboration between the ER and other hospital departments.”

Smits M, Groenewegen PP, Timmermans DR, van der Wal G, Wagner C.  "The nature and causes of unintended events reported at ten emergency departments." BMC Emerg Med. 2009 Sep 18;9(1):16. [Epub ahead of print]

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