Nearly a fourth of patients who are transferred to intensive care units or die in hospitals are misdiagnosed or have delayed diagnoses, according to research published Jan. 8 in JAMA.
In a study of more than 2,400 patient records, researchers employed physician reviewers trained in error adjudications to inspect each EHR for the admission and events leading up to an ICU transfer or death across 90 hospitals.
The researchers work at UCSF Health in San Francisco, Zuckerberg San Francisco General Hospital, the University of Colorado School of Medicine in Aurora, Brigham and Women's Hospital in Boston, and Vizient.
They found that diagnostic errors contributed to temporary harm, permanent harm or death in 436 patients — nearly 80% of all patients in the cohort who were deemed to have diagnostic errors. Of the 2,428 records, 550 patients, or 23%, experienced a diagnostic error.
Among the 1,863 patients who died, diagnostic errors were judged to have contributed to 121 deaths. Within the group of patients who died and had a diagnostic error, the error contributed to 29.4% of the deaths, according to the study.
The two most common types of diagnostic errors were assessment problems, such as recognizing complications, and testing, including choosing the correct test, ordering the test in a timely manner or correctly interpreting results.
"Although deaths and ICU transfers are statistically infrequent and likely represent a seriously ill patient population, the importance of these events in patient safety efforts is paramount," the authors concluded, "making our results immediately useful to hospitals focused on addressing these events."