Inadvertent checking of items is one of the legal risks of electronic medical records. One common scenario: Someone checks a box stating that the patient’s current medications were reviewed. It turns out the patient was taking a medication that was contraindicated to something that was administered in the ED. This can lead to a "he said/she said" situation.
To reduce the likelihood of anaphylaxis-related litigation, researchers recommend additional anaphylaxis education, provision of epinephrine auto injectors or other alternatives to reduce dosing errors, and stronger safeguards to prevent administration of known allergens.
Researchers set out to understand how EPs determine risk and decide to admit patients with low-risk chest pain. They surveyed dozens of emergency medicine residents and faculty about their perceived risk of various scenarios and an admission decision. Physicians used qualitative terms in ways that are different from how those terms are used in typical conversation. This can lead to miscommunication during shared decision-making processes. Investigators discovered that EPs considered any probability greater than 1% for acute coronary syndrome enough of a risk to warrant admission.
The authors of a recent study discovered that a triage chief complaint that was less indicative of appendicitis correlated with a higher rate of missed appendicitis in one pediatric ED. The researchers concluded that their findings suggest the potential impact of anchoring bias by a triage chief complaint when trying to diagnose appendicitis. However, one analyst advises that the results should be interpreted with caution because the study authors did not look for the denominator of chief complaints.
A recent analysis of several dozen closed ED malpractice claims revealed failed opportunities to avert diagnostic errors and bad outcomes. Investigators analyzed 62 claims that closed between 2008 and 2015 at a large malpractice insurer, discovering some common final diagnoses in the cases in which errors were made.
When patients hear about high out-of-pocket costs, did not realize their insurance would leave them with a large balance, or just did not know their copay was so high, registrars often bear the brunt of their frustration.