Patient concerns about medical errors in emergency departments
Patient concerns about medical errors in emergency departments
复制标题
DOI：
10.1197/j.aem.2004.08.052
复制
发表时间：
2005-01-01
影响因子：
4.4
通讯作者：
Fraser, VJ
中科院分区：
文献类型：
--
作者：
Burroughs, TE;Waterman, AD;Fraser, VJ
目的：尽管急诊患者数量众多，但人们对急诊科（ED）患者如何认识自己的医疗差错风险知之甚少。本研究探讨急诊科患者对医疗差错的安全感受，哪些差错是最受关注的，患者和医院的特点对急诊科患者的关注有何不同，以及关注与愿意再次接受未来护理之间的关系。方法：对12个急诊科767例患者进行多波电话访谈。患者被问及他们的医疗安全、对八种医疗差错的关注以及对护理的满意度。结果：88%的患者认为他们对医疗事故的安全性是好的、非常好的或非常好的；38%的患者报告至少经历过一次与特定错误相关的问题，最常见的是误诊（占所有患者的22%），医生错误（16%），药物错误（16%），护理错误（12%）和错误的测试/程序（10%）。担忧与性别（p < 0.01）、年龄（p < 0.0001）、种族（p < 0.001）、住院时间（p < 0.001）、ED容量（p < 0.0001）、周数（p < 0.0001）和医院类型（p < 0.0001）相关。结论：大多数急诊科患者对医疗差错感到相对安全，但很大比例的患者在遇到紧急情况时对特定的差错感到担忧。患者和医院的特点不同，关注的问题也不同，与患者满意度密切相关。关注的选择性可能表明患者对他们认为与特定医疗错误有关的线索很敏感，但是考虑到急诊科遇到的压力和恐吓性质，让患者参与错误检测/预防计划的努力将具有挑战性。
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.