BCE 63 Failing Up after Medical Error

Dr. Sarah Gray tells us the story of her worst case ever and what she learned from it. About 50% of North American physicians involved in a serious medical error report increased anxiety for future errors, decreased confidence in their job, decreased job satisfaction, insomnia, PTSD, panic disorder – the list goes on. Dr. Gray shares how and why many of us react to medical error - the embarrassment, the shame, the guilt and sense of failure. She then explains the notion of acceptance that we all fail, that perfection is a myth, and how she learned that "failing up" after of the most difficult case of her career is the best choice after making a medical error...

Best Case Ever 54 Missed Fracture and Apologizing to Patients

In anticipation of EM Cases Episode 91 Knee Injuries Pearls and Pitfalls Dr. Arun Sayal, creator of the CASTED course, tells his Best Case Ever concerning missed fractures and apologizing to patients. Dr. Sayal reminds us of two basic concepts that are all too often skipped over in our assessment of minor injuries and the effect of apologizing to the patient when you've missed a fracture...

By | 2017-01-17T10:35:54+00:00 January 17th, 2017|Categories: Best Case Ever, EM Cases, Medical Specialty, Trauma|Tags: , , |0 Comments

Episode 11: Cognitive Decision Making and Medical Error

In this episode on Cognitive Decision Making & Medical Error, Dr. Doug Sinclair, CMO of St. Michael's Hospital and Dr. Chris Hicks show us that, while the ED physician's knowledge base may play a small part in predicting medical error, more important might be how we understand and reflect upon our decision-making processes, how we communicate with our staff and patients, and how we cope with the ED environment and shift work. Medical error is the 6th leading cause of death in North America, and despite huge advances in imaging technology and lab testing as well as an explosion of EM literature in recent years, the misdiagnosis rate detected through autopsy studies has not changed significantly over the past century. Studies on diagnostic error in emergency medicine have shown error rates between 1 and 12%, and it's been suggested that cognitive error, or some flaw in the decision making process (as apposed to a lack of knowledge), is present in about 95% of these cases. Dr. Sinclair and Dr. Hicks elucidate for us how to identify and understand cognitive decision making and medical error, and how we can improve our decision making, reduce medical error and optimize the care of our patients.