Quality management and benchmarking in emergency medicine.
OBJECTIVE
Being critical in terms of time and complexity, emergency medicine is exposed to an emerging imperative for quality improvement strategies. We review current concepts and recent advances in the management of quality in emergency medicine.


RESULTS
There is a strong interdependence between quality of emergency healthcare provision and the education of emergency healthcare providers. Introduction of emergency medical residencies and highly qualified triage liaison physicians helps prevent the overcrowding of emergency departments, accelerate access to emergency medical care and improve patient satisfaction. New advances in detecting and reducing patient management errors include the collection of healthcare provider complaints and the classification of unpreventable and preventable deaths of patients within 1 week of admission via the emergency department. Medical record review and video recording have revealed that frequent patient management problems relate to shortcomings in the diagnostic process, clinical tasks, patient factors, and poor teamwork. Communication skills and patient data/documentation systems may effectively resolve these problems.


CONCLUSIONS
According to the available evidence, more performance improvement strategies need to be tested to delineate which process changes would be most effective in improving patient outcome in emergency medicine.
Francis
Roland C E
RC
Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany. roland.francis@charite.de
Spies
Claudia D
CD
Kerner
Thoralf
T
D019985:Benchmarking; D004635:Emergency Medicine / Q000193:education / Q000592:standards*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D019984:Quality Indicators, Health Care; D017749:Total Quality Management