Harmful diagnostic errors may be occurring in as many as 1 in every 14 (7%) hospital patients—at least those receiving general medical care—suggest the findings of a single center study in the US, published online in the journal BMJ Quality & Safety . Most (85%) of these errors are likely preventable and underscore the need for new approaches to improving surveillance to avoid these mistakes from happening in the first place, say the researchers. Previously published reports suggest that current trigger tools for picking up medical mistakes aren't good enough to detect harmful diagnostic errors, including those with less severe outcomes, suggest the researchers.
They therefore developed and validated a structured case review process to enable clinicians to interrogate the electronic health record (EHR) to evaluate the diagnostic process for hospital patients , assess the likelihood of a diagnostic error, and characterize the impact and severity of harm. They used the process to estimate retrospectively the prevalence of harmful diagnostic errors in a randomly selected sample of 675 hospital patients out of a total of 9,147 in receipt of general medical care between July 2019 and September 2021, excluding the height of the COVID-19 pandemic (April–December 2020). Cases deemed to be at high risk of diagnostic error were categorized as: transfer to intensive care 24 or more hours after admission (130; 100%); death within 90 days of admission either in hospital or after dis.
