title: Factors associated with adverse events resulting from medical errors in the emergency department: two work better than one.
abstract: BACKGROUND
  The Emergency Department (ED) is an environment at risk for medical errors.
  
  
  OBJECTIVE
  Our aim was to determine the factors associated with the adverse events resulting from medical errors in the ED among patients who were admitted.
  
  
  METHODS
  This was a prospective observational study. For a 1-month period, we included all ED patients who were subsequently admitted to the medical ward. Detection of medical errors was made by the admitting physician and then validated by two experts who reviewed all available data and medical charts pertaining to the patient's hospital stay, including the first review from the ward physician. Related adverse events resulting from medical errors were then classified by type and severity. Adverse events were defined as medical errors that needed an intervention or caused harm to the patient. Univariate analysis examined relationships between characteristics of both patients and physicians and the risk of adverse events.
  
  
  RESULTS
  From 197 analyzed patients, 130 errors were detected, of these, 34 were categorized as adverse events among 19 patients (10%). Seventy-six percent of these were categorized as proficiency errors. The only factors associated with a lower risk of adverse events were the transition of care involving a handoff within the ED (0% vs. 19%; p = 0.03) and the involvement of a resident (junior doctor) in addition to the senior physician (37% vs. 67%; p < 0.01).
  
  
  CONCLUSIONS
  In our study, the involvement of more than one physician was associated with a lower risk of adverse events.
authors: Service d'Accueil des Urgences, Hôpital Pitié-Salpêtrière, Paris, France.
authors: Yonathan
authors: Y
authors: Freund
authors: Hélène
authors: H
authors: Goulet
authors: Jérôme
authors: J
authors: Bokobza
authors: Aurélie
authors: A
authors: Ghanem
authors: Serge
authors: S
authors: Carreira
authors: Delphine
authors: D
authors: Madec
authors: Gaëlle
authors: G
authors: Leroux
authors: Patrick
authors: P
authors: Ray
authors: Jacques
authors: J
authors: Boddaert
authors: Bruno
authors: B
authors: Riou
authors: Pierre
authors: P
authors: Hausfater
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors
keywords: adverse events; handoffs; medical errors