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Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan
OBJECTIVE: To investigate the reasons for the occurrence of clinically significant adverse events (CSAEs) in emergency department-discharged patients through emergency physicians' (EPs) subjective reasoning and senior EPs' objective evaluation. DESIGN: This was a combined prospective follo...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Group
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582046/ https://www.ncbi.nlm.nih.gov/pubmed/22433586 http://dx.doi.org/10.1136/emermed-2011-200910 |
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author | Wang, Lee-Min How, Chorng-Kuang Yang, Ming-Chin Su, Syi Chern, Chii-Hwa |
author_facet | Wang, Lee-Min How, Chorng-Kuang Yang, Ming-Chin Su, Syi Chern, Chii-Hwa |
author_sort | Wang, Lee-Min |
collection | PubMed |
description | OBJECTIVE: To investigate the reasons for the occurrence of clinically significant adverse events (CSAEs) in emergency department-discharged patients through emergency physicians' (EPs) subjective reasoning and senior EPs' objective evaluation. DESIGN: This was a combined prospective follow-up and retrospective review of cases of consecutive adult non-traumatic patients who presented to a tertiary-care emergency department in Taiwan between 1 September 2005 and 31 July 2006. Data were extracted from ‘on-duty EPs' subjective reasoning for discharging patients with CSAEs (study group) and without CSAEs (control group)’ and ‘objective evaluation of CSAEs by senior EPs, using clinical evidences such as recording history, physical examinations, laboratory/radiological examinations and observation of inadequacies in the basic management process (such as recording history, physical examinations, laboratory/radiological examinations and observation) as the guide’. Subjective reasons for discharging patients’ improvement of symptoms, and the certainty of safety of the discharge were compared in the two groups using χ(2) statistics or t test. RESULTS: Of the 20 512 discharged cases, there were 1370 return visits (6.7%, 95% CI 6.3% to 7%) and 165 CSAEs due to physicians' factors (0.82%, 95% CI 0.75% to 0.95%). In comparisons between the study group and the control group, only some components of discharge reasoning showed a significant difference (p<0.001). Inadequacies in the basic management process were the main cause of CSAEs (164/165). CONCLUSION: The authors recommended that EP follow-up of the basic management processes (including history record, physical examination, laboratory and radiological examinations, clinical symptoms/signs and treatment) using clinical evidence as a guideline should be made mandatory. |
format | Online Article Text |
id | pubmed-3582046 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BMJ Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-35820462013-03-01 Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan Wang, Lee-Min How, Chorng-Kuang Yang, Ming-Chin Su, Syi Chern, Chii-Hwa Emerg Med J Original Article OBJECTIVE: To investigate the reasons for the occurrence of clinically significant adverse events (CSAEs) in emergency department-discharged patients through emergency physicians' (EPs) subjective reasoning and senior EPs' objective evaluation. DESIGN: This was a combined prospective follow-up and retrospective review of cases of consecutive adult non-traumatic patients who presented to a tertiary-care emergency department in Taiwan between 1 September 2005 and 31 July 2006. Data were extracted from ‘on-duty EPs' subjective reasoning for discharging patients with CSAEs (study group) and without CSAEs (control group)’ and ‘objective evaluation of CSAEs by senior EPs, using clinical evidences such as recording history, physical examinations, laboratory/radiological examinations and observation of inadequacies in the basic management process (such as recording history, physical examinations, laboratory/radiological examinations and observation) as the guide’. Subjective reasons for discharging patients’ improvement of symptoms, and the certainty of safety of the discharge were compared in the two groups using χ(2) statistics or t test. RESULTS: Of the 20 512 discharged cases, there were 1370 return visits (6.7%, 95% CI 6.3% to 7%) and 165 CSAEs due to physicians' factors (0.82%, 95% CI 0.75% to 0.95%). In comparisons between the study group and the control group, only some components of discharge reasoning showed a significant difference (p<0.001). Inadequacies in the basic management process were the main cause of CSAEs (164/165). CONCLUSION: The authors recommended that EP follow-up of the basic management processes (including history record, physical examination, laboratory and radiological examinations, clinical symptoms/signs and treatment) using clinical evidence as a guideline should be made mandatory. BMJ Group 2013-03 2012-03-20 /pmc/articles/PMC3582046/ /pubmed/22433586 http://dx.doi.org/10.1136/emermed-2011-200910 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode |
spellingShingle | Original Article Wang, Lee-Min How, Chorng-Kuang Yang, Ming-Chin Su, Syi Chern, Chii-Hwa Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan |
title | Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan |
title_full | Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan |
title_fullStr | Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan |
title_full_unstemmed | Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan |
title_short | Evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in Taiwan |
title_sort | evaluation of clinically significant adverse events in patients discharged from a tertiary-care emergency department in taiwan |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582046/ https://www.ncbi.nlm.nih.gov/pubmed/22433586 http://dx.doi.org/10.1136/emermed-2011-200910 |
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