I was surprised to see in the September issue of the BCMJ that there was not more in the way of concrete specifics about the causes of or solutions to medical errors (theme issue: How do we improve patient safety?).
As an emergency physician of advanced age (61), I am well aware of my own potential for making errors when our department is overcrowded (every evening, for example) and I am unable to deal in a timely manner with patient volumes. It is established fact that malpractice suits in emergency medicine peak dramatically at about 4 a.m. or 5 a.m. due to lessened vigilance and fatigue. I suspect that most people can describe circumstances in which they would be more prone to error, although medical machismo would make self-reporting hopelessly inaccurate. Whether we label these errors “system” or “operator” is, to a large degree, semantic.
I’m somewhat concerned that in our enthusiasm for data and technology, we have not heard more about medical working conditions as a source of errors of commission or omission. I am not convinced that more technology alone is the answer.
—Michael S. Dettman, MD
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
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For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org