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The Impact of Diagnostic Errors in Healthcare

Diagnostic errors, defined as delayed, wrong or miscommunicated diagnoses, pose a serious threat to patient well-being while also driving up healthcare costs. A study done by BMJ estimates that 750,000 Americans suffer serious harm from misdiagnoses annually, resulting in permanent disability or fatality.

Despite Effort, Challenges Remain

A recent report from The Leapfrog Group described responses from 95 hospitals across the U.S. on their implementation of recommended practices to address diagnostic errors, revealing that over 60% of respondents were either implementing or preparing to implement practices known to prevent harm from diagnostic error. While most are open to adoption and agree that these practices are necessary, only a limited number of hospitals are fully implementing these processes, citing staffing shortages and budgetary pressures as barriers to further implementation.

Rising Cost of Medical Malpractice

About three-fourths of serious misdiagnoses-related harms can be attributed to vascular events, infections and cancers, also known as “The Big Three.” These three conditions account for 74.1% of high-severity cases. Another study found that diagnostic error occurs across all surgical specialties, though general surgery, gynecology and orthopedic surgery were most often represented. Only 2.5% of misdiagnosis cases indicate no risk management issues while clinical judgement, communication and clinical systems factors are listed as the leading causes for malpractice claims.

While the frequency of malpractice claims has decreased over the past couple of decades, the cost of these claims has increased exponentially. Medical malpractice claims with indemnity payments greater than $500,000 increased dramatically, with 41 states reporting verdicts greater than $10 million. These errors can cause tremendous harm to patients as well as financial and reputational harm to organizations and physicians.

Preventing Diagnostic Errors

The many factors that contribute to diagnostic errors are present at both organizational and individual levels. Organizational factors include miscommunication, staffing shortages and time limitations, while at an individual level, lack of situational awareness, fatigue and multitasking have been cited. Incomplete or inaccurate patient information and having limited time with patients are also major factors that can lead to error. The diagnostic process is extremely complex, however, there are steps you can take to avoid these costly mistakes. These include:

  • Culture and Leadership: Utilize tools to ensure appropriate delivery of patient data, align improvement goals with established benchmarks and assess the current diagnostic process.
  • Patient and Family Engagement: Close the communication loop among patients, families and providers and develop decision-making tools to promote meaningful diagnosis and treatment discussions.
  • Workplace Procedures and Support: Implement training resources to increase awareness and provide support to employees involved in diagnostic error cases.
  • Learning Systems: Use evidence-based tools to measure errors, review health data to reduce disparities and strengthen analysis processes.
  • Proactive Risk Assessment: Review and analysis of processes can be valuable in helping to identify potential and actual risks and exposures as well as solutions.

Additional Resources on Diagnostic Safety

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