Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan
| Autor: | Ming-Chin Yang, Lee-Min Wang, Chorng-Kuang How, Syi Su, Chii-Hwa Chern |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Risk medicine.medical_specialty Pediatrics CSAEs (clinically significant adverse events) emergency care systems Taiwan Physical examination Critical Care and Intensive Care Medicine Risk Assessment Interviews as Topic medicine Humans Prospective Studies Adverse effect Prospective cohort study Retrospective Studies ED (emergency department) Chi-Square Distribution Medical Errors medicine.diagnostic_test business.industry Retrospective cohort study General Medicine Emergency department Guideline Continuity of Patient Care Patient Discharge aged efficiency Case-Control Studies Radiological weapon Emergency medicine Disease Progression environmental medicine Emergency Medicine Female Original Article Emergency Service Hospital BMP (basic management process) business Chi-squared distribution Follow-Up Studies EPs (emergency physicians) abdomen |
| Zdroj: | Emergency Medicine Journal : EMJ |
| ISSN: | 1472-0213 1472-0205 |
| DOI: | 10.1136/emermed-2011-200910 |
| Popis: | Objective To investigate the reasons for the occurrence of clinically significant adverse events (CSAEs) in emergency department-discharged patients through emergency physicians' (EPs) subjective reasoning and senior EPs' objective evaluation. Design This was a combined prospective follow-up and retrospective review of cases of consecutive adult non-traumatic patients who presented to a tertiary-care emergency department in Taiwan between 1 September 2005 and 31 July 2006. Data were extracted from ‘on-duty EPs' subjective reasoning for discharging patients with CSAEs (study group) and without CSAEs (control group)’ and ‘objective evaluation of CSAEs by senior EPs, using clinical evidences such as recording history, physical examinations, laboratory/radiological examinations and observation of inadequacies in the basic management process (such as recording history, physical examinations, laboratory/radiological examinations and observation) as the guide’. Subjective reasons for discharging patients’ improvement of symptoms, and the certainty of safety of the discharge were compared in the two groups using χ2 statistics or t test. Results Of the 20 512 discharged cases, there were 1370 return visits (6.7%, 95% CI 6.3% to 7%) and 165 CSAEs due to physicians' factors (0.82%, 95% CI 0.75% to 0.95%). In comparisons between the study group and the control group, only some components of discharge reasoning showed a significant difference (p |
| Databáze: | OpenAIRE |
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