Patient concerns about medical errors in emergency departments.
OBJECTIVE
Despite large numbers of emergency encounters, little is known about how emergency department (ED) patients conceptualize their risk of medical errors. This study examines how safe ED patients feel from medical errors, which errors are of greatest concern, how concerns differ by patient and hospital characteristics, and the relationship between concerns and willingness to return for future care.


METHODS
Multiwave telephone interviews of 767 patients from 12 EDs were conducted. Patients were asked about their medical safety, concern about eight types of medical errors, and satisfaction with care.


RESULTS
Eighty-eight percent of patients believed that their safety from medical errors had been good, very good, or excellent; 38% of patients reported experiencing at least one specific error-related concern, most commonly misdiagnosis (22% of all patients), physician errors (16%), medication errors (16%), nursing errors (12%), and wrong test/procedure (10%). Concerns were associated with gender (p < 0.01), age (p < 0.0001), ethnicity (p < 0.001), length of stay (p < 0.001), ED volume (p < 0.0001), day of week (p < 0.0001), and hospital type (p < 0.0001). Concerns were highly related to a patient's willingness to return to the ED.


CONCLUSIONS
The majority of ED patients felt relatively safe from medical errors, yet a significant percentage of patients experienced concern about a specific error during their emergency encounter. Concerns varied by both patient and hospital characteristics and were highly linked to patient satisfaction. The selective nature of concerns may suggest that patients are attuned to cues they perceive to be linked to specific medical errors, but efforts to involve patients in error detection/prevention programs will be challenging given the stressful and intimidating nature of ED encounters.
Burroughs
Thomas E
TE
Center for Outcomes Research, Department of Internal Medicine, St. Louis University, MO 63104, USA. burroute@slu.edu
Waterman
Amy D
AD
Gallagher
Thomas H
TH
Waterman
Brian
B
Adams
David
D
Jeffe
Donna B
DB
Dunagan
William Claiborne
WC
Garbutt
Jane
J
Cohen
Max M
MM
Cira
Jane
J
Inguanzo
Joe
J
Fraser
Victoria J
VJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002983:Clinical Competence; D004636:Emergency Service, Hospital / Q000592:standards* / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011336:Probability; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States