Emergency department clinicians are challenged to maintain their focus in difficult conditions, increasing the risk that an error will occur

6 recommendations to reduce cognitive overload

1. Limit interruptions. Use these 4 strategies:

2. Support all members of the care team to practice at the top of his/her license. Here are 4 strategies:

  • Implement a scribe program

    Medical scribes assist with documentation, reducing the amount of time physicians must spend at the EHR and increasing time for direct patient care. Emergency departments may use scribes to document, perform order entry, admit/discharge, request consults, pull-up prior patient data, and alert providers to new/ important information.

    Case study:

  • Use the pharmacy team

    The pharmacy team may assist with medication selection and safety, care of critically ill patients, antimicrobial stewardship, and calculation of weight-based dosing. Studies show that having a pharmacist on-staff in the ED may reduce medication errors by two-thirds.

  • Use pharmacy technicians

    Use pharmacy technicians to complete medication histories and medication reconciliation. This has been shown to both increase accuracy of medication histories and reduce medication errors by as much as half.

  • Use paramedics within the ED

    Use paramedics within the ED to complete tasks such as triage, starting IVs, and offloading patients from arriving Emergency Medical Services units.

    Case study:

3. Adopt and actively promote the use of cognitive job aids. Here are 3 strategies:

4. Optimize use of the electronic health records (EHR) system. See 3 strategies:

5. Adopt a team-based approach. Use these 2 strategies:

6. Support clinical staff in engaging in self-care. Here are 3 strategies: