In 2013, Pennsylvania hospitals reported 23,749 events to the Pennsylvania Patient Safety Authority in which the emergency department (ED) was selected as the care area. Of these reports, 540 (2.3%) involved patients undergoing care in the time between disposition decision through departure from the ED (i.e., phase III); reported consequences ranged from no-harm events requiring monitoring to events resulting in harm or even death. Several components of this phase have potential safety hazards. Two hundred and thirty-nine events (44.3% of the 540 ED phase III events) involved monitoring the patient until an inpatient bed was available or until the patient was discharged or transferred, and 199 events (36.9%) were gaps in care unrecognized by ED personnel (i.e., identified by another caregiver or department). This article, the third in a series that addresses patient safety related to ED flow, focuses on strategies to improve processes of care and patient safety during ED phase III.
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