Patient Safety in Emergency Medicine

Abstract

The Emergency Department (ED) exists to provide timely and safe emergency care to all patients. However, its unique environment is prone to patient safety issues. Patient safety events, often preventable, happen at an alarming rate in the ED for a variety of reasons. Despite long-standing attempts to mitigate patient safety events in ED patients, such as the enaction of the Emergency Medical Treatment and Labor Act in 1986 and the creation of safety net hospitals, these events persist. Numerous vulnerable and medically underserved populations seek care mainly in the ED, whether due to financial necessity, poor access to care, or cost-prohibitive factors when seeking care elsewhere. Limited information, fragmented records, brief clinical encounters, high-risk patient populations, and high patient volumes all contribute to a complex, error-prone environment. Communication issues, regular interruptions and distractions, and frequent handoffs further add to the issue of patient safety in the ED. Many solutions to mitigate these ED safety issues have been proposed, including using standardized communication tools, limiting interruptions during handoffs, and reducing sequential handoffs through optimizing staffing. Despite many attempts at addressing patient safety, errors persist in ED care. Considering the gravity of ED-based errors and the vulnerable populations who present for emergency care, it is imperative that patient safety be at the forefront of all ED providers’ minds.