Format

Send to

Choose Destination
Diagnosis (Berl). 2016 Jun;3(2):65-69. doi: 10.1515/dx-2015-0033. Epub 2016 May 13.

Primary care pediatricians' interest in diagnostic error reduction.

Author information

1
1Department of Pediatrics, The Children's Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, NY, USA.
2
2Center for Innovations in Quality, Effectiveness and Safety, Michael E. Debakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
3
3Albert Einstein College of Medicine, Bronx, NY, USA.
4
4Columbia University College of Physicians and Surgeons, New York, NY, USA.
5
5Johns Hopkins University School of Medicine, Baltimore, MD, USA.
6
6Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
7
7Vanderbilt University School of Medicine, Nashville, TN, USA.
8
8Jersey Shore University Medical Center, Neptune, NJ, USA9The American Academy of Pediatrics Division of Quality, Quality Improvement Innovation Networks, Elk Grove Village, IL, USA.
9
9The American Academy of Pediatrics Division of Quality, Quality Improvement Innovation Networks, Elk Grove Village, IL, USA.
10
10Medical University of South Carolina, Charleston, SC, USA.

Abstract

BACKGROUND:

Diagnostic errors causing harm in children are understudied, resulting in a knowledge gap regarding pediatricians' interest in reducing their incidence.

METHODS:

Electronic survey of general pediatricians focusing on diagnostic error incidence, errors they were interested in trying to improve, and errors reduced by their electronic health record (EHR).

RESULTS:

Of 300 contacted pediatricians, 77 (26%) responded, 58 (19%) served ambulatory patients, and 48 (16%) completed the entire questionnaire. Of these 48, 17 (35%) reported making a diagnostic error at least monthly, and 16 (33%) reported making a diagnostic error resulting in an adverse event at least annually. Pediatricians were "most" interested in "trying to improve" missed diagnosis of hypertension (17%), delayed diagnosis due to missed subspecialty referral (15%), and errors associated with delayed follow-up of abnormal laboratory values (13%). Among the 44 pediatricians with an EHR, 16 (36%) said it reduced the likelihood of missing obesity and 14 (32%) said it reduced the likelihood of missing hypertension. Also, 15 (34%) said it helped avoid delays in follow-up of abnormal laboratory values. A third (36%) reported no help in diagnostic error reduction from their EHR.

CONCLUSIONS:

Pediatricians self-report an appreciable number of diagnostic errors and were most interested in preventing high frequency, non-life-threatening errors. There exists a need to leverage EHRs to support error reduction efforts.

KEYWORDS:

diagnostic error; pediatrics; primary care

Supplemental Content

Full text links

Icon for Sheridan PubFactory Icon for PubMed Central
Loading ...
Support Center