Factors associated with adverse events resulting from medical errors in the emergency department: two work better than one

J Emerg Med. 2013 Aug;45(2):157-62. doi: 10.1016/j.jemermed.2012.11.061. Epub 2013 Feb 21.


Background: The Emergency Department (ED) is an environment at risk for medical errors.

Objective: Our aim was to determine the factors associated with the adverse events resulting from medical errors in the ED among patients who were admitted.

Methods: This was a prospective observational study. For a 1-month period, we included all ED patients who were subsequently admitted to the medical ward. Detection of medical errors was made by the admitting physician and then validated by two experts who reviewed all available data and medical charts pertaining to the patient's hospital stay, including the first review from the ward physician. Related adverse events resulting from medical errors were then classified by type and severity. Adverse events were defined as medical errors that needed an intervention or caused harm to the patient. Univariate analysis examined relationships between characteristics of both patients and physicians and the risk of adverse events.

Results: From 197 analyzed patients, 130 errors were detected, of these, 34 were categorized as adverse events among 19 patients (10%). Seventy-six percent of these were categorized as proficiency errors. The only factors associated with a lower risk of adverse events were the transition of care involving a handoff within the ED (0% vs. 19%; p = 0.03) and the involvement of a resident (junior doctor) in addition to the senior physician (37% vs. 67%; p < 0.01).

Conclusions: In our study, the involvement of more than one physician was associated with a lower risk of adverse events.

Keywords: adverse events; handoffs; medical errors.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • France
  • Humans
  • Male
  • Medical Errors / statistics & numerical data*
  • Middle Aged
  • Personnel Staffing and Scheduling / statistics & numerical data*
  • Prospective Studies
  • Risk Factors