Upgrades to intensive care: The effects of COVID-19 on decision-making in the emergency department - 29/10/21
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Abstract |
Introduction |
The initial surge of critically ill patients in the COVID-19 pandemic severely disrupted processes at acute care hospitals. This study examines the frequency and causes for patients upgraded to intensive care unit (ICU) level care following admission from the emergency department (ED) to non-critical care units.
Methods |
The number of ICU upgrades per month was determined, including the percentage of upgrades noted to have non-concordant diagnoses. Charts with non-concordant diagnoses were examined in detail as to the ED medical decision-making, clinical circumstances surrounding the upgrade, and presence of a diagnosis of COVID-19. For each case, a cognitive bias was assigned.
Results |
The percentage of upgraded cases with non-concordant diagnoses increased from a baseline range of 14–20% to 41.3%. The majority of upgrades were due to premature closure (72.2%), anchoring (61.1%), and confirmation bias (55.6%).
Conclusion |
Consistent with the behavioral literature, this suggests that stressful ambient conditions affect cognitive reasoning processes.
Le texte complet de cet article est disponible en PDF.Keywords : Emergency medicine, Cognitive bias, Misdiagnosis
Plan
Vol 49
P. 100-103 - novembre 2021 Retour au numéro
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