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Care Team Model and Diagnostic Error Risk in Medical Patients Who Transferred to the ICU or Died
Michelle Knees1, Colin Hubbard2, Marisha Burden3
1Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. michelle.knees@cuanschutz.edu.
Resident teaching teams may reduce diagnostic errors in hospitalized patients compared to direct attending care. Understanding team composition is key for improving diagnostic safety and patient outcomes.
Area of Science:
- Healthcare quality and safety
- Medical team dynamics
- Diagnostic error reduction
Background:
- Diagnostic errors pose significant risks to hospitalized patients.
- Investigating the impact of medical team composition on diagnostic safety is crucial for developing better care models.
Purpose of the Study:
- To compare the risk of diagnostic errors across different hospital care models: direct attending care, resident teaching teams, and advanced practice provider-led (APP) services.
Main Methods:
- Retrospective observational study utilizing average treatment effect and inverse probability of treatment weighting.
- Analysis of 1,544 general medicine patients across 29 US hospitals from 2019.
- Diagnostic errors adjudicated via two-physician chart review, focusing on any diagnostic error and harmful diagnostic error.
Main Results:
- Direct attending care was linked to a higher risk of any diagnostic error compared to resident teaching teams (mRR, 1.36; 95% CI, 1.04-1.68).
- Teaching teams cared for 63% of patients, direct care for 29%, and APP services for 9%.
Conclusions:
- Care team structure appears to influence the risk of diagnostic errors.
- Team-based decision-making and workload distribution within resident teaching models may enhance diagnostic safety.
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