The emergency department (ED) is a critical, fast-paced environment that is susceptible to medical errors. Medical errors are defined as a “preventable adverse event or near miss due to the failure of a planned action to be completed as intended or use of a wrong plan to achieve an aim” (Pham et al., 2012, p. 448). They are the cause of 98,000 annual deaths in the United States. Per the Institute of Medicine (IOM), preventable adverse drug events (ADE) were one of the most prevalent sources of avoidable medical errors with an annual occurrence of 1.5 million events. ADEs are also one of the most expensive errors, costing approximately $3.5 billion each year in the United States in 2006 (Pham et al., 2012). Adverse events were found to take place in 5 to 10% of health incidents with half of the incidents being avoidable (Watters & Truskett, 2013). Among these medical errors are diagnostic errors (incorrect diagnosis or failure to diagnose), which are the leading sources of error in emergency departments (Brown, McCarthy, Kelen & Levy, 2010). Some examples include the medication administration errors, false positive lab test results, unnecessary costs, tests and treatments (Schuur, Hsia, Burstin, Schull, & Pines, 2013). Per a national database of physician malpractice insurers, the payout for diagnostic errors was more than $347 million, which accounted for 46% of emergency department malpractice claims (Brown, McCarthy, Kelen & Levy, 2010). Diagnostic errors alone account for nearly 40,000-80,000 annual deaths in the United States (Pham et al., 2012). Factors in the ED such as psychological stress, fatigue, time pressure, distractions, overwhelming workloads, lack of immediate and complete patient health information can increase the rate of diagnostic errors (Mirvis, 2015). Overcrowding can cause errors such as erroneous documentation and malfunctioning administrative processes in emergency care (Ben-Assuli & Leshno, 2013). Another factor is information overload, which can generate so much anxiety that even coping strategies may become ineffective. Emergency nurse practitioners (ENPs) overwhelmed by these factors can increase the clinical risk to ED patients and increase the risk of ineffective communication (Burley, 2011).
System-related interventions such as health information technology (HIT) have the potential to significantly reduce the rates of diagnostic errors, complications, mortality and costs. In 2005, the Congressional Budget Office (CBO) reported that the HIT implementation could result in net annual savings of $80 billion (Encinosa & Bae, 2011). HIT has also been reported to save the United States nearly $88 billion in costs over 10 years. Some examples of HIT include bar-coded medication administration (BCMA) systems, computerized physician order entry (CPOE), clinical decision support systems (CDSS), electronic medical records (EMR) and electronic health records (EHR). (Agrawal, 2009).
HIT can also notably improve the quality and efficiency of a hospital. After a 41% increase in HIT system adoption, one hospital’s readmission rates decreased by 41% in 2008 through 2012 (Ben-Assuli, Shabtai & Leshno, 2013). In terms of quality, one study from a Latter-Day Saint (LDS) Hospital showed a 55% statistically significant decrease in non-intercepted serious medication errors because of computerized provider entry use. A second study with a time-series design showed an even more significant reduction of 86% in non-intercepted serious medication errors. In terms of efficiency, one study from the Regenstrief Institute found that alerting physicians using computerized order entry resulted in an 11% decrease in treatment delivery time (Chaudhry, 2006). These computer systems can provide a safety net to healthcare providers by lessening their cognitive load. They also back up important patient health files and documents through the aggregation of patient information and feedback assistance (Pham et al., 2012).
This systematic analysis aims to provide a deeper understanding of HIT to healthcare providers, organizations and the public. It considers how diagnostic errors can be reduced in emergency department patients by supplying evidence of positive and negative impacts of HIT from previous academic literature. Providing both perspectives will hopefully assist healthcare providers in becoming more informed about investing in HIT in their organization.
Week One Assignment – Introduction
Please write a 2-4 page introduction to your research proposal. In this section you will include the following information:
· Statement of the problem (What healthcare issues are you addressing in your research proposal)
· Significance of the topic and and explanation of why this should be studied(supported with evidence and statistics)
· Target population (who are you studying)
Below is an example of an introduction
Top of Form
Bottom of Form