Research Activities, September 2013
Study reviews patient safety strategies targeting diagnostic error and identifies promising interventions
Patient Safety and Quality
Missed, delayed, or incorrect diagnosis can lead to inappropriate patient care, poor patient outcomes, and higher costs. A systematic review of 109 studies of patient safety strategies (PSSs) targeted at diagnostic errors has categorized and identified promising interventions that warrant evaluation in large studies across diverse settings.
The evidence seemed strongest for interventions such as technology-based systems (e.g., text message alerting), and specific techniques (e.g., testing equipment adaptations). Over 100 evaluations of interventions to reduce diagnostic errors, many of which had a reported positive effect on at least one end point, were identified by a team of researchers from Stanford University and the Palo Alto Medical Foundation Research Institute.
The researchers grouped the PSSs targeting diagnostic errors from an organizational perspective into changes that an organization might consider more generically (techniques investment; personnel configurations; additional review steps for higher reliability; structured processes; education of professionals, patients, and families; and information and communications technology-based enhancements).
The two most common types of PSSs were structured process changes, most of which involved the addition of a tool, often a checklist or a form, and the introduction of redundancy in interpreting test results, usually by a separate reader. Limited evidence from randomized, controlled trials showed that some interventions, such as text messaging, can reduce diagnostic errors in certain situations. Very few studies evaluated the utility of engaging patients and families in prevention of diagnostic errors. This study was supported by AHRQ (Contract No. 290-07-10062).
For further details, see "Patient safety strategies targeted at diagnostic errors," by Kathryn M. McDonald, M.M., Brian Matesic, B.S., Despina G. Contopoulos-Ioannidis, M.D., and others in the March 5, 2013, Annals of Internal Medicine 158(5) Part 2, pp. 381-389.