Diagnostic Error in Acute Care

Diagnostic error in acute care.
PA-PSRS Patient Saf Advis. 2010;7:76-86.

Analyzing reports of diagnostic errors, this article discusses common causes and provides suggestions for physicians and patients to prevent such events.

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Diagnostic Error in Acute Care


Diagnostic Error in Acute Care
Pa Patient Saf Advis 2010 Sep;7(3):76-86.

ABSTRACT

Errors related to missed or delayed diagnoses are a frequent cause of patient injury and, as such, are an underlying cause of patient safety related events. Autopsy series spanning several decades reveal error rates of 4.1% to 49.8%. Diagnostic errors are encountered in every specialty and are generally lowest, at less than 5%, for perceptual specialties (e.g., radiology, pathology, dermatology) that rely heavily on visual pattern recognition and interpretation. Error rates in other clinical specialties are higher, ranging from 10% to 15%, which is consistent with the added demands of data gathering and synthesis. Additionally, diagnostic errors are frequently the leading or second leading cause of malpractice claims in the United States, accounting for twice as many alleged and settled claims as medication errors. Studies have shown that cognitive errors and system design flaws—especially communication issues—all contribute to diagnostic error. This article reviews the common causes of diagnostic error, the clinical diagnoses most often affected by diagnostic errors, and risk reduction strategies that facilities, diagnosing physicians, and patients themselves can undertake to decrease diagnostic error and increase patient safety.

During the last decade, much emphasis has