TY - CHAP M1 - Book, Section TI - Preface A1 - Shah, Binita R. A1 - Mahajan, Prashant A1 - Amodio, John A1 - Lucchesi, Michael PY - 2019 T2 - Atlas of Pediatric Emergency Medicine, 3e AB - Emergency care is a highly complex, cognitively demanding specialty that is often challenging because providers work in time-, resource-, and information-constrained settings while caring for patients whose illnesses are still evolving. In the United States alone, there are approximately 145 million annual visits to EDs and many more to urgent care settings. The pressures of clinical practice continue to increase with demands on productivity in the face of decreasing reimbursement and a steadily rising volume of patients. All these factors unfortunately have “contaminated” the “art” of medicine (ie, arrival at a diagnosis after careful and comprehensive clinical examination) with the “knee jerk” aspect of indiscriminate ordering of tests to arrive at the diagnosis. The diagnostic process is even more complex in the context of pediatric emergency care not only because of the spectrum of physiological, anatomical, and psychological differences compared with adults but also because many clinicians are uncomfortable with pediatric patients, are inadequately trained, or work in settings that do not have population-specific management resources. The dangers of over- or under-diagnosis, over- or under-testing, or over- or under-treatment is the risk of patient harm. Injury to patients due to diagnostic mishaps is currently recognized as the most important yet understudied aspect of patient safety (ie, “the blind spot” in the patient safety movement.) The National Academies of Science, Engineering, and Medicine has highlighted the importance of making a timely and accurate diagnosis. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1162822112 ER -