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Diagnostic Time-Outs to Improve Diagnosis.
Sarah Yale1, Susan Cohen2, Brett J Bordini1
1Division of Hospital Medicine, Medical College of Wisconsin, Children's Corporate Center, Suite 560, 999 North 92nd Street, Milwaukee, WI 53226, USA.
Critical Care Clinics
|April 4, 2022
Summary
Implementing diagnostic time-outs can reduce medical errors in neonatal intensive care units (NICUs). However, providers perceive time constraints as a barrier, and some underestimate the risk of diagnostic errors impacting patient outcomes.
Area of Science:
- Medical error reduction strategies
- Cognitive forcing functions in healthcare
- Neonatal intensive care unit (NICU) quality improvement
Background:
- Diagnostic errors pose significant risks to patient safety.
- Cognitive forcing functions, such as diagnostic time-outs, show promise in mitigating diagnostic errors.
- Barriers to implementing diagnostic time-outs need to be understood and addressed.
Purpose of the Study:
- To investigate barriers to implementing diagnostic time-outs in a NICU setting.
- To assess NICU providers' perceptions of diagnostic error risk and the impact of time constraints.
- To identify strategies for improving the adoption of diagnostic time-outs.
Main Methods:
- Survey of healthcare providers in a neonatal intensive care unit (NICU).
- Assessment of perceived barriers to diagnostic time-out implementation.
- Comparison of risk perception for diagnostic errors among different provider levels (attendings, nurse practitioners, trainees).
Main Results:
- Perceived time constraints were universally identified as a barrier to diagnostic time-outs.
- Attending neonatologists and nurse practitioners reported lower perceived risk of diagnostic errors impacting outcomes compared to trainees.
- Trainees demonstrated a higher awareness of the potential impact of diagnostic errors.
Conclusions:
- Addressing perceived time constraints is crucial for implementing diagnostic time-outs in NICUs.
- Enhancing provider understanding of diagnostic error nature and impact is necessary.
- Future interventions should focus on overcoming implementation barriers and improving risk perception.
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