Fascinating paper on discharge decision making. They analyzed why the physician discharged.
Most physicians (even these Canadians who we often perceive as being more algorithmic) stated they used clinical judgement (nearly70%) compared to evidence-based reasoning.
Also, the adverse event rate in 366 discharges was low. 10. With only one death. HOWEVER, upon review by 3 trained ED physicians almost all of these were deemed to be PREVENTABLE.
Its a provocative paper and offers and interesting discussion on discharge decision making which is one of the heaviest tasks we have.
Here is the Paper.