Errors of Diagnosis in Pediatric Practice: A Multisite Survey
| Autor: | Kenneth Pietz, Lindsey Wilson, Dena Elkeeb, P. Adam Kelly, Hardeep Singh, Geeta Singhal, Eric J. Thomas |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Delayed Diagnosis Adolescent Attitude of Health Personnel MEDLINE Physical examination Risk Assessment Article Patient safety Surveys and Questionnaires medicine Humans Diagnostic Errors Practice Patterns Physicians' Child Probability medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) Infant medicine.disease United States Appendicitis El Niño Child Preschool Health Care Surveys Population Surveillance Family medicine Pediatrics Perinatology and Child Health Needs assessment Linear Models Female Clinical Competence Risk assessment business Needs Assessment |
| Zdroj: | Pediatrics. 126:70-79 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2009-3218 |
| Popis: | OBJECTIVE: We surveyed pediatricians to elicit their perceptions regarding frequency, contributing factors, and potential system- and provider-based solutions to address diagnostic errors. METHODS: Academic, community, and trainee pediatricians (N = 1362) at 3 tertiary care institutions and 109 affiliated clinics were invited to complete the survey anonymously through an Internet survey administration service between November 2008 and May 2009. RESULTS: The overall response rate was 53% (N = 726). More than one-half (54%) of respondents reported that they made a diagnostic error at least once or twice per month; this frequency was markedly higher (77%) among trainees. Almost one-half (45%) of respondents reported diagnostic errors that harmed patients at least once or twice per year. Failure to gather information through history, physical examination, or chart review was the most-commonly reported process breakdown, whereas inadequate care coordination and teamwork was the most-commonly reported system factor. Viral illnesses being diagnosed as bacterial illnesses was the most-commonly reported diagnostic error, followed by misdiagnosis of medication side effects, psychiatric disorders, and appendicitis. Physicians ranked access to electronic health records and close follow-up of patients as strategies most likely to be effective in preventing diagnostic errors. CONCLUSION: Pediatricians reported making diagnostic errors relatively frequently, and patient harm from these errors was not uncommon. |
| Databáze: | OpenAIRE |
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