Editing Emergency medicine (section)

====Medical error====
Many circumstances, including the regular transfer of patients in emergency treatment and crowded, noisy and chaotic ED environments, make emergency medicine particularly susceptible to [[medical error]] and near misses.<ref name=":0">{{cite book |doi=10.1002/9781118292150 |title=Ethical Problems in Emergency Medicine |year=2012 |isbn=9781118292150 |editor1-last=Jesus |editor1-first=John |editor2-last=Grossman |editor2-first=Shamai A |editor3-last=Derse |editor3-first=Arthur R |editor4-last=Adams |editor4-first=James G |editor5-last=Wolfe |editor5-first=Richard |editor6-last=Rosen |editor6-first=Peter}}</ref><ref name=":1">{{cite journal |doi=10.1016/s0196-0644(03)00398-6 |pmid=12944883 |title=Errors in a busy emergency department |journal=Annals of Emergency Medicine |volume=42 |issue=3 |pages=324–33 |year=2003 |last1=Fordyce |first1=James |last2=Blank |first2=Fidela S.J. |last3=Pekow |first3=Penelope |last4=Smithline |first4=Howard A. |last5=Ritter |first5=George |last6=Gehlbach |first6=Stephen |last7=Benjamin |first7=Evan |last8=Henneman |first8=Philip L.}}</ref> One study identified an error rate of 18 per 100 registered patients in one particular academic ED.<ref name=":1" /> Another study found that where a lack of teamwork (i.e. poor communication, lack of team structure, lack of cross-monitoring) was implicated in a particular incident of ED medical error, "an average of 8.8 teamwork failures occurred per case [and] more than half of the deaths and permanent disabilities that occurred were judged avoidable."<ref>{{cite journal |doi=10.1016/s0196-0644(99)70134-4 |pmid=10459096 |title=The Potential for Improved Teamwork to Reduce Medical Errors in the Emergency Department |journal=Annals of Emergency Medicine |volume=34 |issue=3 |pages=373–83 |year=1999 |last1=Risser |first1=Daniel T |last2=Rice |first2=Matthew M |last3=Salisbury |first3=Mary L |last4=Simon |first4=Robert |last5=Jay |first5=Gregory D |last6=Berns |first6=Scott D}}</ref> Particular cultural (i.e. "a focus on the errors of others and a 'blame-and-shame' culture") and structural (i.e. lack of standardisation and equipment incompatibilities) aspects of emergency medicine often result in a lack of disclosure of medical error and near misses to patients and other caregivers.<ref name=":0" /><ref>{{cite journal |doi=10.1111/j.1553-2712.2008.00147.x |pmid=19086213 |title=Emergency Medical Services Provider Perceptions of the Nature of Adverse Events and Near-misses in Out-of-hospital Care: An Ethnographic View |journal=Academic Emergency Medicine |volume=15 |issue=7 |pages=633–40 |year=2008 |last1=Fairbanks |first1=Rollin J. |last2=Crittenden |first2=Crista N. |last3=o'Gara |first3=Kevin G. |last4=Wilson |first4=Matthew A. |last5=Pennington |first5=Elliot C. |last6=Chin |first6=Nancy P. |last7=Shah |first7=Manish N. |doi-access=free}}</ref> While concerns about malpractice liability are one reason why disclosure of medical errors is not made, some have noted that disclosing the error and providing an apology can mitigate malpractice risk.<ref>{{Cite web|url=http://news.health.com/2010/08/17/when-doctors-admit-mistakes-fewer-malpractice-suits-result-study-says/|title=When Doctors Admit Mistakes, Fewer Malpractice Suits Result, Study Says|date=2010-08-17|website=Health News / Tips & Trends / Celebrity Health|access-date=2016-11-19|archive-url=https://web.archive.org/web/20161128195708/http://news.health.com/2010/08/17/when-doctors-admit-mistakes-fewer-malpractice-suits-result-study-says/|archive-date=28 November 2016|url-status=dead}}</ref> Ethicists uniformly agree that the disclosure of a medical error that causes harm is a care provider's duty.<ref name=":0" /> The critical components of the disclosure include "honesty, explanation, empathy, apology, and the chance to lessen the chance of future errors" (represented by the mnemonic HEEAL).<ref name=":0" /><ref>{{cite journal |doi=10.1001/jama.289.8.1001 |pmid=12597752 |title=Patients' and Physicians' Attitudes Regarding the Disclosure of Medical Errors |journal=JAMA |volume=289 |issue=8 |pages=1001–7 |year=2003 |last1=Gallagher |first1=Thomas H. |last2=Waterman |first2=A. D. |last3=Ebers |first3=A. G. |last4=Fraser |first4=V. J. |last5=Levinson |first5=W |doi-access=free}}</ref> The nature of emergency medicine is such that error will likely always be a substantial risk of emergency care. However, maintaining public trust through open communication regarding a harmful error can help patients and physicians constructively address problems when they occur.<ref name=":0" />