Preferred language and diagnostic errors in the pediatric emergency department
Jeremiah T Lowe1, Jan Leonard2, Fidelity Dominguez3
1University of Colorado School of Medicine, Aurora, CO, USA.
Diagnosis (Berlin, Germany)
|October 5, 2023
Summary
Non-English primary language (NEPL) did not increase the risk of diagnostic errors (DxE) in pediatric emergency departments. This study found similar rates of DxE in both English-proficient and NEPL groups.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Patient Safety
Background:
- Diagnostic errors (DxE) are a significant concern in pediatric emergency departments (EDs).
- Caregiver language proficiency may influence communication and diagnostic accuracy.
- Understanding language barriers is crucial for improving patient safety.
Purpose of the Study:
- To examine the association between caregiver primary language and the occurrence of DxE in the pediatric ED.
- To compare the rates of DxE between English-proficient (EP) and non-English primary language (NEPL) groups.
Main Methods:
- A retrospective review of ED encounters from January 2018 to February 2022 was conducted.
- Electronic triggers identified unplanned hospital admissions within 10 days of an index ED visit.
- The Revised Safer Dx instrument was used to confirm DxE, categorizing caregivers by language proficiency.
Main Results:
- Of 3,551 triggered encounters, 806 underwent review, with 172 (21.3%) confirmed DxE.
- The proportion of DxE was comparable between EP (21.5%) and NEPL (21.7%) groups (p=0.97).
- Older age (≥12 years) and fewer prior admissions predicted higher DxE odds; NEPL was not a predictor.
Conclusions:
- Caregiver non-English primary language was not associated with an increased risk of diagnostic errors leading to unplanned hospital admission.
- These findings suggest language proficiency is not a significant independent risk factor for DxE in this pediatric ED setting.
- Further research may explore other factors contributing to DxE in diverse linguistic populations.
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