Date of Publication
Introduction. The Institute of Medicine defines diagnostic error as the failure to establish an accurate or timely explanation for the patient's health problem(s), or effectively communicate the explanation to the patient. To our knowledge, no studies exist characterizing diagnostic error from patient perspectives using this definition.
Objective. We sought to characterize diagnostic errors experienced by patients and describe patient perspectives on causes, impacts, and prevention strategies.
Methods. We screened 77 adult inpatients at University of Vermont Medical Center and conducted 27 structured interviews with patients who experienced diagnostic error in the past five years. We performed qualitative analysis using Grounded Theory.
Results. In the past five years, 39% of interviewed patients experienced diagnostic error. The errors mapped to the following categories: accuracy (30%), communication (34%) and timeliness (36%). Poor communication (13 responses) and inadequate time with doctors (7) were the most identified causes of errors. Impacts of errors included emotional distress (17 responses), adverse health outcomes (7) and impaired activities of daily living (6). Patients suggested improved communication (11 responses), clinical management (7) and access to doctors (5) as prevention strategies. For communication, patients rated "talk to your doctor" highest (mean 8.4, on 1-10 Likert scale) and "text message" lowest (4.8).
Conclusions/Recommendations. Diagnostic errors are common and have dramatic impact on patients' well-being. We suggest routine surveillance to identify errors, support for patients who have experienced errors, and implementation of patient and provider "checklists" to enhance communication. Future studies should investigate strategies to allow care providers adequate time with patients.
Allen Repp, University of Vermont Medical Center
University of Vermont Medical Center
Health Communication and Health Information Technology, Medical Product Safety
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This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License
Couperus, Cody J.; Kolli, Sree Sahithi; Munoz, Sergio Andres; Self, Quinn; Reeves, Russell R.; Worswick, Erica; York, Sterling A.; and Repp, Allen B., "Diagnostic Medical Errors: Patient's Perspectives on a Pervasive Problem" (2017). Public Health Projects, 2008-present. 246.