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Providers’ and Patients’ Perspectives on Diagnostic Errors in the Acute Care Setting

Published:November 23, 2022DOI:https://doi.org/10.1016/j.jcjq.2022.11.009

      ABSTRACT

      Background

      Diagnostic errors (DE) have been studied extensively in ambulatory care, but less work has been done in the acute care setting. In this study, we examined healthcare providers’ and patients’ perspectives about the classification of DEs, the main causes and scope of DEs in acute care, the main gaps in current systems, and the need for innovative solutions.

      Methods

      We conducted a qualitative mixed methods study, including semi-structured interviews with healthcare providers and focus groups with patient advisors. Using grounded theory approach, thematic categories were derived from the interviews and focus groups.

      Results

      We conducted interviews with 17 providers and two focus groups with seven patient advisors. Both providers and patient advisors struggled to define and describe DEs in acute care settings. While participants agreed that DEs pose a significant risk to patient safety, their perception of the frequency of DEs was mixed. Most participants identified communication failures, lack of comfort with diagnostic uncertainty, incorrect clinical evaluation, and cognitive load as key causes of DEs. Most respondents believed that non-IT tools and processes (e.g., communication improvement strategies) could significantly reduce DEs.

      Conclusions

      The study findings represent an important supplement to our understanding of DEs in acute care settings and the advancement of a culture of patient safety in the context of patient-centered care and patient engagement. Healthcare organizations should consider the key factors identified in this study when trying to create a culture that engages clinicians and patients in reducing DEs.

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