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Primary care pediatricians’ interest in diagnostic error reduction

  • Michael L. Rinke EMAIL logo , Hardeep Singh , Sarah Ruberman , Jason Adelman , Steven J. Choi , Heather O’Donnell , Ruth E.K. Stein , Tammy M. Brady , Moonseong Heo , Christoph U. Lehmann , Steven Kairys , Elizabeth Rice-Conboy , Keri Theissen and David G. Bundy
Published/Copyright: May 13, 2016
Diagnosis
From the journal Diagnosis Volume 3 Issue 2

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
Corresponding author: Michael L. Rinke, MD, PhD, Department of Pediatrics, The Children’s Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, NY, USA, Phone: +718-741-2524, Fax: +718-920-4351

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: Drs. Rinke, Singh, Adelman, Choi, O’Donnell, and Bundy, and Ms. Rice-Conboy and Ms. Theissen were supported by the Agency for Healthcare Research and Quality (HS023608-01). Dr. Brady is supported by the NIH/NHLBI (HL119622-01).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplemental Material:

The online version of this article (DOI: 10.1515/dx-2015-0033) offers supplementary material, available to authorized users.

Received: 2015-12-21
Accepted: 2016-4-23
Published Online: 2016-5-13
Published in Print: 2016-6-1

©2016 by De Gruyter

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https://doi.org/10.1515/dx-2015-0033
Keywords for this article
diagnostic error; pediatrics; primary care

Articles in the same Issue

  1. Frontmatter
  2. Opinion Paper
  3. Healthcare is a giant with feet of clay
  4. Original Articles
  5. Diagnosis is a team sport – partnering with allied health professionals to reduce diagnostic errors
  6. An investigation into method of diagnosis in clinicopathologic conferences (CPCs)
  7. Primary care pediatricians’ interest in diagnostic error reduction
  8. Spurious elevation of serum potassium concentration measured in samples with thrombocytosis
  9. Mobile phone exposure influences some erythrocytes parameters in vitro. A novel source of preanalytical variability?
  10. Case Reports
  11. Those eyes don’t lie: a case of osmotic demyelination syndrome in a patient with hepatic encephalopathy
  12. CA-125: What does that lab really mean?
  13. Letter to the Editor
  14. Assessment of reticulated platelets with automated hemocytometers: are we measuring the same thing?
  15. Congress Abstracts
  16. Diagnostic Error in Medicine 1st European Conference June 30–July 1, 2016
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