Bedside Clinicians' Perceptions on the Contributing Role of Diagnostic Errors in Acutely Ill Patient Presentation: A Survey of Academic and Community Practice. Issue 2 (March 2022)

• Record Type: Journal Article
• Authors: Huang, Chanyan; Barwise, Amelia; Soleimani, Jalal; Dong, Yue; Svetlana, Herasevich; Khan, Syed Anjum; Gavin, Anne; Helgeson, Scott A.; Moreno-Franco, Pablo; Pinevich, Yuliya; Kashyap, Rahul; Herasevich, Vitaly; Gajic, Ognjen; Pickering, Brian W.
• Is Part Of: Journal of patient safety. Volume 18:Issue 2(2022)
• Page Start: e454
• Page End: e462
• Publication Date: 2022-03
• Subjects: diagnostic errors -- acutely ill patients -- rapid response team -- unplanned ICU admission -- communication -- subspecialty consultation -- survey; Patients -- Safety measures -- Periodicals; Medicine -- Practice -- Safety measures -- Periodicals; Medical errors -- Prevention -- Periodicals; 610.289
• DOI: 10.1097/PTS.0000000000000840
• Languages: English
• ISSNs: 1549-8417

Abstract

Abstract : Supplemental digital content is available in the text. Abstract : Objectives: This study aimed to explore clinicians' perceptions of the occurrence of and factors associated with diagnostic errors in patients evaluated during a rapid response team (RRT) activation or unplanned admission to the intensive care unit (ICU). Methods: A multicenter prospective survey study was conducted among multiprofessional clinicians involved in the care of patients with RRT activations and/or unplanned ICU admissions (UIAs) at 2 academic hospitals and 1 community-based hospital between April 2019 and March 2020. A study investigator screened eligible patients every day. Within 24 hours of the event, a research coordinator administered the survey to clinicians, who were asked the following: whether diagnostic errors contributed to the reason for RRT/UIA, whether any new diagnosis was made after RRT/UIA, if there were any failures to communicate the diagnosis, and if involvement of specialists earlier would have benefited that patient. Patient clinical data were extracted from the electronic health record. Results: A total of 1815 patients experienced RRT activations, and 1024 patients experienced UIA. Clinicians reported that 18.2% (95/522) of patients experienced diagnostic errors, 8.0% (42/522) experienced a failure of communication, and 16.7% (87/522) may have benefitted from earlier involvement of specialists. Compared with academic settings, clinicians in the community hospital were less likely to report diagnostic errors (7.0% versus 22.8%, P = 0.002). Conclusions: Clinicians report a high rate of diagnostic errors in patients they evaluate during RRT or UIAs.