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- Audit and Feedback
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- Discontinuities, Gaps, and Hand-Off Problems
- Error Analysis
Cases & Commentaries
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F. Daniel Duffy, MD; Christine K. Cassel, MD; October 2007
Following surgery, a woman on a patient-controlled analgesia pump is found to be lethargic and incoherent, with a low respiratory rate. The nurse contacted the attending physician, who dismisses the patient's symptoms and chastises the nurse for the late call.
Journal Article > Commentary
Retrieval medicine: a review and guide for UK practitioners. Part 2: safety in patient retrieval systems.
Hearns S, Shirley PJ. Emerg Med J. 2006;23:943-947.
The authors describe the retrieval and transfer of critically ill patients from one environment to another and provide recommendations for making this process as safe and reliable as possible.
Journal Article > Study
Redfern E, Brown R, Vincent CA. Emerg Med J. 2009;26:658-661.
Implementation of structured processes improved emergency department communication in two areas: communication between paramedics and emergency department staff, and documentation of the patient's initial clinical condition by physicians.