A recent study found that emergency departments (EDs) are a big source of mistakes in medical care and tried to pinpoint at least some of the reasons.

Expenses for insurers

The study is a project of an insurance company that covers medical professionals against malpractice lawsuits. The insurer says ED misdiagnosis is a major expense for the company.

Their research report notes that one-third of all claims the company receives are for ED diagnosis-related claims. Further, such claims account for 47% of the payouts the company makes.

What makes EDs so unusual?

The company calls the emergency department a “unique and complex ecosystem” and only medical professionals who have done time in one knows what they are like.

They identify four broad factors that make EDs so unique and uniquely prone to claims of misdiagnosis:

  • The pace of work in an ED can be intense, drop to zero and quickly spring back again leading to limits in understanding, organizing and communicating.
  • The stress of knowing that almost anything can burst through the front door at any minute makes staff forever ready for action that may never come.
  • The severity of issues like gunshot wounds, traffic accidents, heart attacks, burns and seizures require intense focus that may be hard to release at the end of a shift.
  • The lack of information about patients can prevent accurate diagnosis, as patient medical histories are often unavailable, the right language interpreters may not be on hand and patients are often unaccompanied and unconscious.

The study found that the ED is like “the first domino in a chain of falling dominos.” Many errors that occur later, the study said, stem from the emergency room and