scholarly journals Implementation of an Orthopedic Trauma Program to Safely Promote Resident Autonomy

2019 ◽  
Vol 11 (2) ◽  
pp. 207-213 ◽  
Author(s):  
Brian W. Yang ◽  
Peter M. Waters
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Patient Safety ◽  
Tertiary Hospital ◽  
Surgical Trauma ◽  
Complication Rates ◽  
Hospital Emergency Department ◽  
Orthopedic Trauma ◽  
Hospital Emergency ◽  
Technical Errors

ABSTRACT Background  There is ongoing tension in graduate medical education between progressive resident autonomy with entrustable professional activities and the need for supervision to ensure patient safety. Objective  We implemented a pediatric orthopedic surgical trauma safety program that utilized a postcall review conference to provide residents graduated responsibility learning opportunities during overnight trauma call without compromising patient safety. Methods  In the program, all orthopedic trauma cases seen in our main tertiary hospital emergency department by the overnight orthopedic resident were reviewed in a case conference. For 1 year, we performed an analysis of all fracture patients who were treated in the emergency department by our orthopedic surgery residents. From June 1, 2016, through June 30, 2017, all care delivery encounters were reviewed for decision-making errors, technical errors, and complication rates. Two resident groups rotated through our institution over the course of the study. Results  During the year of analysis, all 1298 fracture patients seen overnight in the main tertiary hospital emergency department were reviewed. From the first to the second halves of their rotations, the rate of resident decision-making errors (3.1% [12 of 385] to 2.3% [9 of 399]) and technical errors (9.1% [35 of 395] to 7.3% [29 of 399]) decreased. Excluding decision-making and technical errors, the complication rate for patients discharged home was 3.4% (27 of 784). Conclusions  Residents demonstrated decreased decision-making and technical error rates on overnight call while maintaining low complication rates.

scholarly journals Relationship between Healthcare Provider’s Perception about Patient Safety and Patient Safety Implementation in The Emergency Department

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Yayan Mulyana ◽  
Yanny Trisyani ◽  
Etika Emaliyawati
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Regional Hospital ◽  
P Value ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Staff Perceptions ◽  
Team Collaboration ◽  
Collaboration And Communication ◽  
The Relationship

The Emergency Department (ED) is a hospital service unit that provides the first service for patients with disease conditions that threaten their lives or can cause disability for 24 hours. Implementation of patient safety in the ED should be applied to minimize the risk of error handling for the patient. ED staff perceptions related to the implementation of patient safety is a factor that directly-related to his behavior in applying the implementation of patient safety. This study aimed to analyze the relationship between perceptions of staff ED and patient safety by implementing patient safety at the Regional Hospital Emergency Department Cirebon. This study was a correlational study with the cross-sectional approach of 99 emergency staff with total sampling at Cirebon. Collecting data used questionnaires of patient safety. Based on the results of the univariate analysis showed that the majority (80%) of respondents either category on the implementation of the sub-variables of patient safety team collaboration and communication, only a small proportion of respondents less category (20%) on the implementation of the sub-variables of patient safety team collaboration and communication. In addition, less than half (49.5%) category lacking in implementing patient safety, only half (50.5%) categories, both in the implementation of patient safety. Based on the results of the bivariate analysis showed that the relationship implementation of patient safety with all the variables, namely teamwork (p-value = 0.000), communications (p-value = 0.005), the concept of patient safety (p-value = 0.005), and perception (p-value = 0.005). Based on the results of the study, the researchers concluded that the relationship between staff perceptions of the emergency department (ED) on patient safety by implementing patient safety at the Regional Hospital emergency department (RSD) Cirebon. IGD support staff perceptions of patient safety, but still found lacking in the category of health workers implementation of patient safety, so the need for patient safety education and training with simulation methods to illustrate the approach in the implementation of patient safety.

scholarly journals Trends in dental-related visits to a tertiary hospital emergency department in Saudi Arabia

2021 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
NadaA Alsulaiman ◽  
RaghadA Alammar ◽  
MoathA Alabdullatif ◽  
AbdullahM Alwhaibi ◽  
LubnaT Alkadi
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Tertiary Hospital ◽  
Hospital Emergency Department ◽  
Hospital Emergency

scholarly journals Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

2018 ◽  
Vol 9 (1) ◽  
pp. 7 ◽  
Author(s):  
Ephrem Abebe ◽  
Michelle A. Chui
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Human Factors ◽  
Medication Safety ◽  
Original Research ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Safety Hazards ◽  
Work Related ◽  
Junior Staff

Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach. Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures. Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts. Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties". Treatment of Human Subjects: IRB review/approval required and obtained   Type: Original Research

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