Patients' Perspectives of Diagnostic Error: A Qualitative Study

Area of Science:

• Medical error analysis
• Patient safety research
• Qualitative health research

Background:

• Diagnostic error is defined by the Institute of Medicine (IOM) as a failure in accurate, timely, or communicated explanation of a patient's health problem.
• Understanding patient experiences is crucial for addressing diagnostic errors effectively.

Purpose of the Study:

• To characterize diagnostic errors from the patient perspective using the IOM definition.
• To describe patient-identified causes, impacts, and prevention strategies for diagnostic errors.

Main Methods:

• Qualitative interviews with hospitalized adult patients at an academic medical center.
• Thematic analysis of interview data guided by the IOM's diagnostic error framework.
• Descriptive statistics to summarize quantitative findings.

Main Results:

• 27 out of 69 patients reported at least one diagnostic error within the past 5 years.
• Errors were equally distributed across accuracy, communication, and timeliness dimensions.
• Key themes for causes and prevention included limited physician time, communication, clinical assessment, and management; impacts included emotional distress and adverse health outcomes.

Conclusions:

• Diagnostic errors are frequently reported by hospitalized adults and profoundly affect patient well-being.
• Patient insights offer valuable perspectives on diagnostic error causes and prevention.
• Identifying these patient-driven insights can guide interventions to reduce diagnostic errors.