Systematic physician cross-checking between emergency department physicians is associated with a significant reduction in adverse events.

Abstract

Randomised crossover trial.1 Setting: 6 Emergency departments (EDs) in France. Patients: Random sample of adults (mean age 57.5 years) attending the EDs between 8:30 and 16:00 on a weekday, within one of two 10-day inclusion periods. 1680 patients in total (840 in each arm). Intervention: Attendance during periods of cross-checking. This comprised a brief case presentation by one ED physician followed by feedback from a second ED physician, occurring three times per day. Outcomes: Rates of ED medical error, defined as preventable serious adverse events (injuries that might have resulted from medical care or lack thereof, but could have been prevented) or near misses (medical errors with the potential to cause an adverse event but which did not, either by chance or after an intervention). These errors were determined by a two-level review with the initial screening of charts by an …