Delays and interruptions in the acute medical unit clerking process: an observational study

Basey, Avril Janette; Kennedy, Thomas D.; Mackridge, Adam J.; Krska, Janet

doi:10.1177/2054270415619323

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…29 -32 The medical literature associates interruptions with a negative impact on patient safety, workflow, job satisfaction, and mental health. 33 -41 The radiology literature recognizes the detrimental effect interruptions can have on interpretation accuracy, workflow, consultations with other specialties, cost to health care, and patient safety. 16,17,20,36,42 -46 Reconciling the value of communication with the recognized negative impacts on reporting and care delivery is challenging.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Radiology Result Communication in the Emergency Department

et al. 2020

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Purpose: To assess the pattern of result communication that occurs between radiologists and referring physicians in the emergency department setting. Methods: An institutional review board–approved prospective study was performed at a large academic medical center with 24/7 emergency radiology cover. Emergency radiologists logged information regarding all result-reporting communication events that occurred over a 168-hour period. Results: A total of 286 independent result communication events occurred during the study period, the vast majority of which occurred via telephone (232/286). Emergency radiologists spent 10% of their working time communicating results. Similar amounts of time were spent discussing negative and positive cross-sectional imaging examinations. In a small minority of communication events, additional information was gathered through communication that resulted in a change of interpretation from a normal to an abnormal study. Conclusions: Effective and efficient result communication is critical to care delivery in the emergency department setting. Discussion regarding abnormal cases, both in person and over the phone, is encouraged. However, in the emergency setting, time spent on routine direct communication of negative examination results in advance of the final report may lead to increased disruptions, longer turnaround times, and negatively impact patient care. In very few instances, does the additional information gained from the communication event result in a change of interpretation?

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Section: Discussionmentioning

confidence: 99%

Evaluating Radiology Result Communication in the Emergency Department

et al. 2020

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“…5 For example, a UK team conducted a single site observational study (four one-week periods over 18 months involving 36 staff and 71 patients) identifying delays in 44% of admissions. 6 An observational and interview study from the same team demonstrated 46% (318/688) of medication charts contained errors, the majority of which involved omission of medication. This study highlighted variances in medication history-taking including a lack of collaborative histories before prescribing.…”

Section: Introductionmentioning

confidence: 99%

Learning from patient safety incidents involving acutely sick adults in hospital assessment units in England and Wales: a mixed methods analysis for quality improvement

et al. 2021

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Objective Six per cent of hospital patients experience a patient safety incident, of which 12% result in severe/fatal outcomes. Acutely sick patients are at heightened risk. Our aim was to identify the most frequently reported incidents in acute medical units and their characteristics. Design Retrospective mixed methods methodology: (1) an a priori coding process, applying a multi-axial coding framework to incident reports; and, (2) a thematic interpretative analysis of reports. Setting Patient safety incident reports (10 years, 2005–2015) collected from the National Reporting and Learning System, which receives reports from hospitals and other care settings across England and Wales. Participants Reports describing severe harm/death in acute medical unit were identified. Main outcome measures Incident type, contributory factors, outcomes and level of harm were identified in the included reports. During thematic analysis, themes and metathemes were synthesised to inform priorities for quality improvement. Results A total of 377 reports of severe harm or death were confirmed. The most common incident types were diagnostic errors ( n = 79), medication-related errors ( n = 61), and failures monitoring patients ( n = 57). Incidents commonly stemmed from lack of active decision-making during patient admissions and communication failures between teams. Patients were at heightened risk of unsafe care during handovers and transfers of care. Metathemes included the necessity of patient self-advocacy and a lack of care coordination. Conclusion This 10-year national analysis of incident reports provides recommendations to improve patient safety including: introduction of electronic prescribing and monitoring systems; forcing checklists to reduce diagnostic errors; and increased senior presence overnight and at weekends.

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“…2 However, healthcare poses risks to all patients, and it is well documented that acutely sick patients are at heightened risk of unsafe care due to medication errors, treatment delays and complications arising from multiple care handovers. [3][4][5][6] Patient safety is predicated on understanding why errors occur and using this to redesign care to mitigate or remove risks to future patients. Incident reporting systems offer a means to learn from patient safety incidents and improve future practice.…”

Section: Introductionmentioning

confidence: 99%