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PSNet: Patient Safety Network
Journal Article
Study

The Diagnostic Error Index: a quality improvement initiative to identify and measure diagnostic errors.

Perry MF, Melvin JE, Kasick RT, et al. J Pediatr. 2020;Epub Dec 11 .

Diagnostic errors remain an ongoing patient safety challenge and can result in patient harm. This article describes one large pediatric hospital's experience using a systematic methodology to identify and measure diagnostic errors. The quality improvement (QI) project used five domains (autopsy reports, root cause analyses (RCAs), voluntary reporting system, morbidity & mortality conference, and abdominal pain trigger tool) and adjudication by a QI team to identify cases of diagnostic error; Morbidity & mortality conferences, RCAs and abdominal trigger tool identified the majority (91%) of diagnostic errors.