Contributors to Diagnostic Error or Delay in the Acute Care Setting: A Survey of Clinical Stakeholders

Author:

Redmond Sarah1ORCID,Barwise Amelia2,Zornes Sarah1,Dong Yue3,Herasevich Svetlana3,Pinevich Yuliya3,Soleimani Jalal3,LeMahieu Allison4,Leppin Aaron15,Pickering Brian3

Affiliation:

1. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA

2. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA

3. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA

4. Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, MN, USA

5. Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, MN, USA

Abstract

Diagnostic error or delay (DEOD) is common in the acute care setting and results in poor patient outcomes. Many factors contribute to DEOD, but little is known about how contributors may differ across acute care areas and professional roles. As part of a sequential exploratory mixed methods research study, we surveyed acute care clinical stakeholders about the frequency with which different factors contribute to DEOD. Survey respondents could also propose solutions in open text fields. N = 220 clinical stakeholders completed the survey. Care Team Interactions, Systems and Process, Patient, Provider, and Cognitive factors were perceived to contribute to DEOD with similar frequency. Organization and Infrastructure factors were perceived to contribute to DEOD significantly less often. Responses did not vary across acute care setting. Physicians perceived Cognitive factors to contribute to DEOD more frequently compared to those in other roles. Commonly proposed solutions included: technological solutions, organization level fixes, ensuring staff know and are encouraged to work to the full scope of their role, and cultivating a culture of collaboration and respect. Multiple factors contribute to DEOD with similar frequency across acute care areas, suggesting the need for a multi-pronged approach that can be applied across acute care areas.

Funder

agency for healthcare research and quality

society of critical care medicine

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

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