Reducing emergency department charting and ordering errors with a room number watermark on the electronic medical record display.

A survey of Emergency Department (ED) clinicians (ie, physicians, nurses and clinical assistants) at a single hospital in Honolulu, Hawai'i was conducted to assess the frequency of errors in charting, and entering orders on the wrong patient's chart in the electronic medical record (EMR), and clinician opinion was sought on whether a simple watermark of the patient's room number might help reduce the number of these EMR "wrong patient errors." ED clinicians (68 total surveys) were asked if and how often they charted in the wrong patient's chart or entered an order (physicians only) in the wrong patient's chart. Physicians had a combined self-reported average error rate of 1.3%. Mean rate of patient charting errors occurred at 0.5 errors and 0.4 errors per 100 hours, for nurses and clinical assistants, respectively. The majority (81%) of the 68 clinicians surveyed felt that a room number watermark would eliminate most of the wrong patient errors. In conclusion, charting on the wrong patient and order entry on the wrong patient type errors occur with varying frequencies amongst ED clinicians. Nearly all the clinicians believe that a room number watermark might be an effective strategy to reduce these errors.