Missed diagnosis in the emergency department can result in unplanned hospitalization due to complications from worsening symptoms. In this study, pediatric patients with and without missed emergency department diagnosis were compared to determine differences in outcomes and hospital utilization. Children with missed diagnosis of appendicitis or new-onset diabetic ketoacidosis experienced more complications, hospital days and readmissions; there was no difference for sepsis diagnosis.

The Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS) use a variety of quality indicators to measure and rank hospital performance. In this study, researchers analyzed the variance between AHRQ pediatric quality indicators and CMS hospital-acquired condition indicators and evaluated the use of alternative composite scores. The researchers identified substantial within-hospital variation across the indicators and could not identify a single composite measure capable of capturing all of the variance observed across the broad range of outcomes. The authors call for additional research to identify meaningful approaches to performance ranking for children’s hospitals.

… errors , including delayed diagnoses, continue to be a patient safety concern. This case-control study of children … procedures. … Michelson KA, Reeves SD, Grubenhoff JA, et al. Clinical features and preventability of delayed diagnosis …

Medication reconciliation is critical to safe medication use. This prospective cohort study identified high rates of unintentional medication discrepancies among hospitalized children and young adults. The authors conclude that current medication reconciliation practices are inadequate to ensure medication safety.

Medication compounding is prone to dosing errors. This study found that the majority of reviewed home parenteral nutrition preparations, which must be individually compounded based on caloric and nutrient needs, had at least one discrepancy between the formulation prescribed and dispensed. The authors recommend routine reconciliation of home parenteral nutrition compounds with prescriptions to prevent errors.

… the risk of antibiotic-resistant infections and is a recognized patient safety risk. A WebM&M commentary discusses catastrophic complications …

… suggesting that resistance to checklist use is not a major barrier in this setting. …

… Saf … This retrospective review of incident reports at a tertiary care hospital revealed that errors related to …