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Rates of perceived medical errors and its correlation with work-related factors and personal distress among emergency physicians in China: a national cross-sectional study
  1. Shijiao Yan1,2,
  2. Jing Wang3,
  3. Xiaoxv Yin3,
  4. Chuanzhu Lv4,5,
  5. Jianxiong Wu3,
  6. Nan Jiang3,
  7. Zhenyuan Chen3,
  8. Ketao Mu6,
  9. Guopeng Zhang7,
  10. Yanhong Gong3
  1. 1Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People’s Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
  2. 2School of Public Health, Hainan Medical University, Haikou, Hainan, China
  3. 3Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  4. 4Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
  5. 5Department of Emergency Medicine, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
  6. 6Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
  7. 7Department of Nuclear Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
  1. Correspondence to Dr Yanhong Gong, Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; gongyanhong{at}hust.edu.cn

Abstract

Purpose Medical errors are a global concern, and specifically, EDs are at considerable risk for medical errors. Few studies focus on the healthcare provider’s self-perceived medical errors in hospitals, let alone the ED. Hence, this study explored perceived medical errors and their correlation with work-related factors and personal distress among physicians in EDs in China.

Methods From July 2018 to August 2018, a national web-based cross-sectional study was conducted. The link to the web-based questionnaire was posted on the emergency physicians’ working platform, inviting Chinese licensed emergency physicians to participate anonymously in this survey. Our outcome of interest, medical errors, was investigated using self-reporting methods. Occupational stress was assessed using the Chinese version of the Effort-Reward Imbalance scale. The Patient Health Questionnaire, the subscale of the 10-item Positive and Negative Affect Schedule, the subscale of the validated Leiden Quality of Work Questionnaire and the 10-item Generalised Self-efficacy Scale were used to assess personal distress. Logistic regression analysis was used to determine factors significantly associated with perceived medical errors.

Results A sample of 10 457 emergency physicians completed the survey. Almost half (43.63%) of physicians reported self-perceived medical errors during the previous 3 months. The rate of workplace verbal aggression, effort-reward imbalance and depressive symptoms were 81.81%, 78.39% and 35.71%, respectively. Medical errors were more likely to be reported among chief physicians, and those who reported the department was short-staffed for physicians, and who experienced workplace verbal aggression and intense work stress. Medical errors were significantly associated with negative affect and lower self-efficacy.

Conclusion Self-perceived medical errors are prevalent among physicians working in EDs and are associated with their workplace environment and personal distress. Targeted interventions are required to reduce physicians’ workload and improve their working environment. Accounting for healthcare providers’ distress is imperative for reducing the incidence of medical errors and improving their health.

  • emergency department
  • epidemiology
  • mental disorders
  • safety
  • medical errors

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • SY and JW are joint first authors.

  • Handling editor Mary Dawood

  • SY and JW contributed equally.

  • Contributors SY: conception, design of the work, acquisition, interpretation of data. J Wang: conception, design of the work, analysis, interpretation of data, software. XY: conception, design of the work, supervision. CL: conception, acquisition. J Wu: acquisition, interpretation of data. NJ: interpretation of data, software. ZC: acquisition, analysis, interpretation of data, software. KM: conception, design of the work. GZ conception, design of the work. YG: conception, design of the work, analysis, interpretation of data, software, supervision. YG is guarantor.

  • Funding This study was supported by the Major Science and Technology Projects (ZDKJ202004), Key Research and Development Programme (ZDYF2020112), Department of science and technology of Hainan Province, and the Key Laboratory of Emergency and Trauma (Hainan Medical University), Ministry of Education (Grant KLET-201912).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.