Radiographic interpretation in the emergency department

Brunswick, Joan; Ilkhanipour, Kaveh; Seaberg, David C.; McGill, Leasa

doi:10.1016/s0735-6757(96)90045-5

Cited by 47 publications

(25 citation statements)

References 13 publications

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“…This was consistent with other researchers' reports that problems with initial radiographic interpretations may contribute to treatment changes, adverse outcomes, and malpractice claims in the ED. [20][21][22] This is also an excellent example of how practice patterns of other services can affect care provided in the ED. Such findings can drive quality improvement programs designed to improve the reliability of radiographic reports, improve interdepartmental communication, and engender shared responsibility for emergency patients.…”

Section: Discussionmentioning

confidence: 99%

Cause-and-effect Analysis of Risk Management Files to Assess Patient Care in the Emergency Department

et al. 2004

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Objectives: Identifying the etiologies of adverse outcomes is an important first step in improving patient safety and reducing malpractice risks. However, relatively little is known about the causes of emergency department-related adverse outcomes. The objective was to describe a method for identification of common causes of adverse outcomes in an emergency department. This methodology potentially can suggest ways to improve care and might provide a model for identification of factors associated with adverse outcomes. Methods: This was a retrospective analysis of 74 consecutive files opened by a malpractice insurer between 1995 and 2000. Each risk-management file was analyzed to identify potential causes of adverse outcomes. The main outcomes were rater-assigned codes for alleged problems with care (e.g., failures of communication or problems related to diagnosis). Results: About 50% of cases were related to injuries or abdominal complaints. A contributing cause was found in 92% of cases, and most had more than one contributing cause. The most frequent contributing categories included failure to diagnose (45%), supervision problems (31%), communication problems (30%), patient behavior (24%), administrative problems (20%), and documentation (20%). Specific relating factors within these categories, such as lack of timely resident supervision and failure to follow policies and procedures, were identified. Conclusions: This project documented that an aggregate analysis of risk-management files has the potential to identify shared causes related to real or perceived adverse outcomes. Several potentially correctable systems problems were identified using this methodology. These simple, descriptive management tools may be useful in identifying issues for problem solving and can be easily learned by physicians and managers.

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Section: Discussionmentioning

confidence: 99%

Cause-and-effect Analysis of Risk Management Files to Assess Patient Care in the Emergency Department

et al. 2004

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“…58 Gratton et al found a 2.8% rate of clinically significant errors in an EM residency program. 59 The investigators pointed out difficulty in using such ratings as quality measures because the results varied depending on definition and whether one included borderline cases in rate calculations.…”

Section: System-level Approachesmentioning

confidence: 99%

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Schenkel

2000

Academic Emergency Medicine

135

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Abstract. An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice.

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“…Failure to recognize these bony landmarks on standard radiographic views has the potential to give rise to problems regarding communication and the identification of fractures and dislocations. This may result in foot and ankle radiographs being frequently misread [2]. In clinical practice interpretation of these images may be difficult because of the variety of possible injuries and their sometimes-inconspicuous appearances [3].…”

Section: Discussionmentioning

confidence: 99%

Interpretation of Normal Foot and Ankle Radiographs by Accident & Emergency and Orthopaedic Clinicians

C¹

2014

Emergency Medicine

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The purpose of this study was to assess the ability of clinicians dealing with foot and ankle trauma to interpret plain radiographs of the foot and ankle in standard views.A survey of 47 clinicians was conducted between November and December 2010. House officers, senior house officers (SHOs) and specialist registrars (SpRs) from the Emergency and Orthopaedic departments were recruited. Participants were supervised identifying 12 standard bones/landmarks on four images of normal foot and ankle radiographs.A significant difference was found between Emergency and Orthopaedics clinicians (p=0.01), in favour of the Orthopaedic group. Emergency SHOs correctly identified only seventy per cent of the structures assessed in this study.Orthopaedic trainees scored higher. Failure to recognize these bony landmarks may give rise to problems regarding the identification of fractures and dislocations. There is a deficiency in the knowledge and application of radiographic anatomy across Emergency clinicians, particularly evident in SHOs.

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Radiographic interpretation in the emergency department

Cited by 47 publications

References 13 publications

Cause-and-effect Analysis of Risk Management Files to Assess Patient Care in the Emergency Department

Cause-and-effect Analysis of Risk Management Files to Assess Patient Care in the Emergency Department

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Interpretation of Normal Foot and Ankle Radiographs by Accident & Emergency and Orthopaedic Clinicians

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