Interprofessional team membership stability and medical errors in emergency departments

Abstract

Introduction

Delays to care and treatment in emergency departments (EDs) can lead to medical errors that harm patients. To optimize ED outcomes, indicators exist that define time frames within which patients should be assessed, receive care, and be discharged and they include time to triage, time to physician assessment (PIA), and time to discharge. The purpose of this study was to examine the relationship between temporal TMS and medical errors as delays to care in EDs. Methods: A nonexperimental, quantitative, cross-sectional, and correlational research design was used to study the relationship between differences in IP team membership due to shift work schedules (i.e., TMS) and medical errors as patient outcomes within EDs. Fifteen EDs and urgent care centres (referred collectively as EDs) located in the province of Manitoba, Canada were selected for this study. Results: medical errors occurred at each ED but to different extents; ED teams had low temporal stability; TMS and medical errors were not statistically significant, but worked experience captured by the individual team competence index (ITCI) decreased time to physician and length of stay was. TMS had a negative moderating effect on ITCI and neither TMS nor ITCI were statistically significant when patient volumes and levels of acuity were controlled. In contrast, when team size was controlled, TMS had a large effect size on time to physician. Conclusion: low TMS was not a significant factor in medical errors measured as delays to care but probably related to other organizational factors and team dynamics.