Re: Patient safety

I was surprised to see in the September issue of the BCMJ that there was not more in the way of concrete specifics about the causes of or solutions to medical errors (theme issue: How do we improve patient safety?).

As an emergency physician of advanced age (61), I am well aware of my own potential for making errors when our department is overcrowded (every evening, for example) and I am unable to deal in a timely manner with patient volumes. It is established fact that malpractice suits in emergency medicine peak dramatically at about 4 a.m. or 5 a.m. due to lessened vigilance and fatigue. I suspect that most people can describe circumstances in which they would be more prone to error, although medical machismo would make self-reporting hopelessly inaccurate. Whether we label these errors “system” or “operator” is, to a large degree, semantic.

I’m somewhat concerned that in our enthusiasm for data and technology, we have not heard more about medical working conditions as a source of errors of commission or omission. I am not convinced that more technology alone is the answer.

—Michael S. Dettman, MD
Vancouver

Michael Dettman, MD,. Re: Patient safety. BCMJ, Vol. 48, No. 9, November, 2006, Page(s) 434 - Letters.



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