Leveraging diagnostic timeouts to foster interprofessional communication

Area of Science:

• Patient Safety
• Healthcare Quality Improvement
• Nursing Practice

Background:

• Diagnostic errors contribute to significant patient harm.
• Cognitive biases and communication issues often underlie diagnostic errors.
• Diagnostic timeouts (DTOs) are inconsistently implemented as a diagnostic reassessment tool.

Purpose of the Study:

• To evaluate a nurse-driven DTO framework.
• To enhance interprofessional communication.
• To improve diagnostic accuracy in a pediatric hospital.

Main Methods:

• A DTO framework was developed and piloted on a pediatric acute care unit.
• Nurses received education on DTOs and used standardized prompts.
• Feasibility and acceptability were assessed via surveys and qualitative feedback.

Main Results:

• 13 nurse-initiated DTOs occurred over six months.
• Nearly half of DTOs prompted additional workup, and two led to care escalation.
• Qualitative feedback indicated improved communication, psychological safety, and teamwork.

Conclusions:

• Pilot implementation of the nurse-driven DTO framework was feasible and well-received.
• The framework supports structured diagnostic reassessment.
• Future work will focus on broader implementation and impact on psychological safety.