Urgent Matters: Improving Safety in Massachusetts Emergency Departments

Safety risks exist in all care settings, but emergency medicine professionals face unique challenges as they strive to deliver safe, high quality care. Patient volume in emergency departments is high and unpredictable. Decisions are made under intense time pressure, often with limited information. And ED clinicians must contend with frequent interruptions that disrupt workflow, and a staffing mix that varies day-to-day. Conditions like these, if not addressed, can lead to adverse events.

In response to these concerns, the MA College of Emergency Physicians asked the Betsy Lehman Center to partner on an initiative to support safety improvement by EDs across the state. The MA Emergency Nurses Association and the MA Association of Physician Assistants also joined this effort.

An Expert Panel of patients, physicians, pharmacists, nurses, physician assistants, emergency medicine technicians and administrators from across the state was convened. The panel elected to focus on interventions that can be executed from “within the four walls” of the ED in three key areas: (1) crowding; (2) cognitive overload; and (3) care coordination. The resulting recommendations are paired with practical strategies and tools to support implementation. Included are over 25 case studies contributed by Massachusetts hospitals describing best practices they use to promote safety in their own EDs.

recommendations, tools and case studies