A recent study conducted by researchers from Brigham and Women’s Hospital, in collaboration with the University of California San Francisco, has provided new insights into the prevalence and impact of diagnostic errors in hospital settings. The research, which analyzed electronic health records from 29 hospitals across the United States, focused on 2,428 patients who had either been transferred to an intensive care unit (ICU) or died in the hospital. The findings revealed that 23% of these patients experienced a diagnostic error, with the majority of these errors having harmful consequences for the patients.
The study, published in the Journal of the American Medical Association Internal Medicine, aimed to identify the common causes of diagnostic errors in hospitals. According to senior author Jeffrey L. Schnipper, MD, MPH, from Brigham’s Division of General Internal Medicine and Primary Care, understanding the causes and impacts of these errors is crucial for hospitals to effectively reduce their occurrence.
The researchers found that diagnostic errors in hospitals were mainly attributed to errors in testing and errors in assessing patients. This knowledge offers new opportunities to address these issues and improve patient care. Diagnostic errors are defined as failures in accurately explaining a patient’s health problem or effectively communicating this information to the patient. Efforts to detect and address the causes of diagnostic errors are underway, including the Diagnostic Centers of Excellence program at Brigham and Women’s Hospital, which focuses on decreasing errors in medical imaging.
Previous studies on diagnostic errors in hospitals have been limited, making this research significant in quantifying the prevalence of these errors and identifying their underlying causes. The study involved teams of two physicians trained in error adjudication and quality control measures to assess the cases for diagnostic errors.
Out of the 2,428 patients analyzed, 550 (23%) experienced a diagnostic error during their hospital stay. Of these, 486 patients (17% of the total) suffered harm due to these errors. Additionally, 121 of the 1,863 patients who died had a diagnostic error identified as a contributing factor.
While the study acknowledges that only a minority of hospital deaths are linked to diagnostic errors, the researchers emphasize that even one preventable death is too many. The study highlights that errors in assessing patients and ordering and interpreting diagnostic tests were the main factors contributing to diagnostic errors.
The researchers emphasize that the rate of diagnostic errors in the specific population of patients studied does not represent the general rate of diagnostic errors across all hospitals. Moving forward, the researchers plan to explore the implementation of surveillance systems to detect diagnostic errors in real-time, compare results across hospitals, and pilot test potential solutions.
Jeffrey L. Schnipper concludes, “Our study does not provide an overall frequency of diagnostic errors in hospitals, but it does indicate that there is more we can do to prevent these errors and improve patient outcomes.”
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