The Effect of Clinical Experience on the Error Rate of Emergency Physicians
Presented at the Society for Academic Emergency Medicine annual meeting, May 2006, San Francisco, CA.
Received 18 July 2007; received in revised form 28 September 2007, 15 October 2007 and 2 January 2008; accepted 24 January 2008. published online 20 March 2008.
Refers to article:
The Error of Counting “Errors”
, 14 April 2008
Robert L. Wears
Annals of Emergency Medicine
November 2008 (Vol. 52, Issue 5, Pages 502-503) Full Text |
Full-Text PDF (62 KB)
Study objective
We assess the effect of emergency physicians' clinical experience on the propensity to commit a patient care error.
Methods
Seven years of data from a single emergency department's peer review activities were reviewed for all patient care errors made by emergency physicians. Emergency physician clinical experience was defined as years since completion of residency training during the year each error was made. A repeated-measures log-linear model was constructed that predicted error count and the rate of errors over time, with a correction for number of patients treated by each physician.
Results
Of 829 cases reviewed during 7 years, there were 374 emergency physician errors identified. Mean emergency physician experience was 8.1±8.6 years. Emergency physicians with experience of 1.5 years or more were less likely to make an error (relative risk [RR]=0.66; 95% confidence interval [CI] 0.48 to 0.91) than those who were less experienced. Errors were not associated with emergency physician age (RR=1.01; 95% CI 0.99 to 1.03) or sex (RR=1.29; 95% CI 0.93 to 1.79).
Conclusion
Emergency physicians with less than 1.5 years of clinical experience may be more likely to commit errors than more experienced emergency physicians.
Emergency Department, Detroit Receiving Hospital and Department of Emergency Medicine, Wayne State University, Detroit, MI
Address for correspondence: William A. Berk, MD, Department of Emergency Medicine, 6G University Health Center, 4201 St. Antoine, Detroit, MI 48201; 313-745-3331
Supervising editor: John C. Moorhead, MD, MS
Author contributions: WAB, PDL, BFB, and PJS conceived the study. WAB, RDW, PDL, GJK, BFB, and PJS designed the study. WAB designed the trial. WAB drafted the article. RDW, PDL, JTJ, CA, GJK, JJK, BFB, and PJS assisted in manuscript preparation. RDW provided statistical analysis and advice. JTJ, CA, and JJK were responsible for data collection and organization. WAB takes responsibility for the paper as a whole.
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.
Earn CME Credit: Continuing Medical Education is available for this article at: www.ACEP-EMedHome.com.
Publication dates: Available online March 19, 2008.
ABSTRACT