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Search results for "Electronic Health Records"
- Electronic Health Records
- Emergency Medicine
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Journal Article > Study
Mortality risks associated with emergency admissions during weekends and public holidays: an analysis of electronic health records.
Walker AS, Mason A, Quan TP, et al. Lancet. 2017 May 9; [Epub ahead of print].
The weekend effect (higher mortality for patients in acute care settings on weekends compared to weekdays) has led to widespread concerns about hospital staffing. This retrospective study examined whether mortality for emergency admissions at four hospitals in the United Kingdom differed on weekends compared to weekdays. Unlike prior studies of the weekend effect, this study included multiple specific markers of patients' illness severity as well as hospital workload. Investigators found higher mortality associated with being admitted to the hospital during weekends compared to weekdays, but a significant proportion of the observed weekend effect was explained by severity of patient illness. They used three measures to approximate hospital workload: total number of admissions, net admissions (subtracting discharges from admissions), and percentage of beds occupied. None of these workload measures was associated with mortality. The authors conclude that differences in illness severity rather than health care team staffing explain the weekend effect. A recent PSNet interview discussed the weekend effect in health care.
Cases & Commentaries
The Case of Mistaken Intubation
- Spotlight Case
- CME/CEU
- Web M&M
Maria J. Silveira, MD, MA, MPH; June 2016
An older man with multiple medical conditions was found hypoxic, hypotensive, and tachycardic. He was taken to the hospital. Providers there were unable to determine the patient's wishes for life-sustaining care, and, unaware that he had previously completed a DNR/DNI order, they placed him on a mechanical ventilator.
Newspaper/Magazine Article
EHRs in the ER: as doctors adapt, concerns emerge about medical errors.
Luthra S. Kaiser Health News. March 1, 2016.
Many emergency departments have recently implemented electronic health records, which has introduced new safety hazards. This news article reports on challenges associated with the growing use of electronic health records in emergency care, including insufficient usability and increased risk of documentation errors.
Journal Article > Commentary
Patient safety in the emergency department.
Farmer BM. Emerg Med. 2016;48:396-404.
Emergency departments are high-risk environments due to the urgency of care needs and complexity of communication. This commentary explores challenges associated with medication administration, handoffs, discharge processes, and electronic health records in emergency medicine and recommends strategies to reduce risks.
Journal Article > Study
Reducing emergency department charting and ordering errors with a room number watermark on the electronic medical record display.
Yamamoto LG. Hawaii J Med Public Health. 2014;73:322-328.
This survey found that physicians chart or write orders in the wrong patient's electronic health record 1.3% of the time, with significant errors for nurses and clinical assistants as well. Respondents believed that a simple solution such as a prominent room number watermark on the screen would prevent such errors, reinforcing the need to be able to augment electronic health record interfaces to improve safety.
Journal Article > Study
Activation of a medical emergency team using an electronic medical recording–based screening system.
Huh JW, Lim CM, Koh Y, et al. Crit Care Med. 2014;42:801-808.
This study describes the experience of a medical emergency team (MET) at a large academic medical center in South Korea. Approximately half of the MET activations were triggered by an electronic medical record–based screening system, resulting in better outcomes compared with patients who had MET activations from other sources.
Cases & Commentaries
DRESSed for Failure
- Web M&M
Erika Abramson, MD, MS, and Rainu Kaushal, MD, MPH; September 2013
After a new electronic health record was introduced without automatically transferring patients' allergy information to the corresponding fields, a woman was given an antibiotic she was allergic to, which resulted in her being admitted to the intensive care unit.
Journal Article > Commentary
Development of a modified early warning score using the electronic medical record.
Albert BL, Huesman L. Dimens Crit Care Nurs. 2011;30:283-292.
This commentary describes how one hospital developed an early warning score system to improve rapid response team deployment.
Cases & Commentaries
Recurrent Hypoglycemia: A Care Transition Failure?
- Spotlight Case
- Web M&M
Ted Eytan, MD, MS, MPH; October 2008
An elderly, non–English-speaking man with diabetes was admitted to the hospital twice in 8 days due to hypoglycemia. At discharge, the patient was instructed not to take any antidiabetic medications. In between hospitalizations, he saw his primary care physician, who restarted an antidiabetic medication.
Cases & Commentaries
One ACE Too Many
- Web M&M
David N. Juurlink, BPhm, MD, PhD; July 2006
A patient presenting to the ED with chest pain was ruled out for MI, and discharged on an ACE inhibitor. Two weeks later, he returns with a critically elevated potassium level, has a cardiac arrest, and dies.
Cases & Commentaries
Discharge Fumbles
- Spotlight Case
- Web M&M
Alan Forster, MD, MSc; December 2004
A patient arrives at the ED in acute kidney failure; another patient arrives at the ED profoundly hypoglycemic. Both mishaps were determined to stem from medication errors at the time of discharge.