Developments in trauma and emergency medicine
Professor Mark Fitzgerald, director of the Trauma Service at The Alfred, recently presented to the Lander & Rogers’ Health Law team and its clients about developments in trauma and emergency medicine, specifically around risk minimisation.
According to Professor Fitzgerald, errors are very common in health care, although most of the time the impact for the patient will be minimal.
Traditionally, the health care system has focussed on errors of commission (acts) rather than errors of omission (failures). However, Professor Fitzgerald said it is errors of omission that should be the greater focus of training. 85% of poor outcomes arise from failures to do certain things in the course of medical treatment, as opposed to procedures being performed incorrectly. By implementing adequate systems, hospitals can reduce the number and impact of errors.
In Australia, trauma care is of a high quality. Our trauma systems have an integrated, overlapping structure, with teams of doctors responsible for ensuring patient survival and risk minimisation, prior to patients being referred for specialist care.
In Victoria, if an unconscious patient presents to an emergency department, there is an 85% chance that they will survive. However, the world average is approximately 15-20%. Our success arises from increasing standardisation/protocolisation in care processes, and an understanding that decision support systems can minimise risk.
We are seeing further developments, including the standardisation of patient handover with electronic support, and the involvement of doctors in triaging to encourage efficiency. In the future, we will likely see the introduction of automated resuscitation systems with a view to eliminating human error.
In Professor Fitzgerald’s view, the most important consideration in health care should be that “everything that is meant to be done, is done”. It appears that our health care system is improving its systems in accordance with this philosophy.