The following is a summary of “Can Asking Emergency Physicians Whether or Not They Would Have Done Something Differently (WYHDSD) be a Useful Screening Tool to Identify Emergency Department Error?” published in the  September 2023 issue of Emergency Medicine by Arastehmanesh, et al.

Error in emergency care remains prevalent and challenging to recognize. Questioning the emergency physicians about whether or not they would have taken an alternative course of action (“Would you have done something differently?”) is useful for this purpose. [WYHDSD]) is sometimes a helpful indicator for spotting mistakes.

Between 2017 and 2021, prospective data were gathered on all patients who presented to an academic ED. The following criteria were used to locate all cases: When one of the following occurs:  readmission to the ED within 72 hours; transfer to the critical care unit from the floor within 24 hours of admission; death within 24 hours of arrival; or patient or provider complaint. A computerized system randomly assigned cases to emergency doctors, who then examined them for mistakes and complications. Then, in the course of handling the case, reviewers were obligated to respond to WYHDSD.

A total of 6,672 cases were analyzed within the study’s time frame. No mistakes were detected in 5,847 out of 5,857 situations when reviewers said they would not change anything. When predicting errors, the WYHDSD question had a sensitivity of 97.4 % and a negative predictive value of 99.8%. Situations where the reviewer would have done something differently (WHDSD) had a considerably greater proportion of near misses, adverse events, and mistakes due to an adverse event than situations where they would not have. As a result, inquiring about WHDSD among reviewers has the potential to serve as a marker for detecting inaccuracy and enhancing ED treatment.

Source: sciencedirect.com/science/article/abs/pii/S0736467923003037