Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors
| Autor: | Joseph A. Grubenhoff, Juri Boguniewicz, Sarah K. Parker, Jan Leonard, Justin B Searns, Manon C. Williams, Ann L Wirtz, Christine E. MacBrayne |
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| Rok vydání: | 2020 |
| Předmět: |
Handshake
Clinical Biochemistry Psychological intervention Medicine (miscellaneous) 01 natural sciences Antimicrobial Stewardship 03 medical and health sciences Patient safety 0302 clinical medicine SAFER Humans Antimicrobial stewardship Medicine 030212 general & internal medicine Diagnostic Errors 0101 mathematics Child Retrospective Studies business.industry Health Policy 010102 general mathematics Biochemistry (medical) Public Health Environmental and Occupational Health Reproducibility of Results Hospitals Pediatric medicine.disease Inter-rater reliability Primary treatment Stewardship Medical emergency business |
| Zdroj: | Diagnosis. 8:347-352 |
| ISSN: | 2194-802X 2194-8011 |
| Popis: | Objectives Few studies describe the impact of antimicrobial stewardship programs (ASPs) on recognizing and preventing diagnostic errors. Handshake stewardship (HS-ASP) is a novel ASP model that prospectively reviews hospital-wide antimicrobial usage with recommendations made in person to treatment teams. The purpose of this study was to determine if HS-ASP could identify and intervene on potential diagnostic errors for children hospitalized at a quaternary care children’s hospital. Methods Previously self-identified “Great Catch” (GC) interventions by the Children’s Hospital Colorado HS-ASP team from 10/2014 through 5/2018 were retrospectively reviewed. Each GC was categorized based on the types of recommendations from HS-ASP, including if any diagnostic recommendations were made to the treatment team. Each GC was independently scored using the “Safer Dx Instrument” to determine presence of diagnostic error based on a previously determined cut-off score of ≤1.50. Interrater reliability for the instrument was measured using a randomized subset of one third of GCs. Results During the study period, there were 162 GC interventions. Of these, 65 (40%) included diagnostic recommendations by HS-ASP and 19 (12%) had a Safer Dx Score of ≤1.50, (Κ=0.44; moderate agreement). Of those GCs associated with diagnostic errors, the HS-ASP team made a diagnostic recommendation to the primary treatment team 95% of the time. Conclusions Handshake stewardship has the potential to identify and intervene on diagnostic errors for hospitalized children. |
| Databáze: | OpenAIRE |
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