Communication is key for patient safety and treatment in emergency rooms in Rhode Island and across the country. Mistakes made simply because a doctor or nurse did not get information from someone else that they needed to make a proper diagnosis, decision to admit or discharge order, are entirely avoidable.
Insurer Circo/RMF suggested organizational changes in hospitals and emergency rooms can improve patient care and reduce medical malpractice costs. The insurer also noted, "While diagnosis-related missteps are often attributed to cognitive error on the part of the physician, the group identified communication problems and information gaps as present in many of the malpractice cases."
The critical outcome related to these information gaps (misdiagnosing a patient and discharging them, only to have them suffer a substantial worsening of their condition or, in the worst case, death) illustrates the importance of correcting the systemic issues that allow errors to happen.
Gaps in "key information streams," revealed in the report included:
- Availability of prior historical information from the medical record or referring physician
- Changes in the patient's status or a persistently abnormal vital sign
- Timeliness of laboratory or radiology data
- Communication from the consultant physician
- Miscommunication at patient hand-offs
- Barriers to effective communication between the nurse and physician caring for the patient
Medical malpractice cases function as a check on a hospital's emphasis on efficiency, the casualties of that focus being patients who die or are injured because a doctor had to make a rushed or inadequately informed decision.
The data used for the insurer's report was taken from closed malpractice cases from the insurer. While not often acknowledged by insurers, many system improvements are triggered by lawsuits.
Source: Wall Street Journal, "Hospitals Overhaul ERs to Reduce Mistakes," 5/10/2011