Preferred language and diagnostic errors in the pediatric emergency department.

IF 2.2 Q2 MEDICINE, GENERAL & INTERNAL

Diagnosis Pub Date : 2023-10-06 eCollection Date: 2024-02-01 DOI:10.1515/dx-2023-0079

Jeremiah T Lowe, Jan Leonard, Fidelity Dominguez, Kaitlin Widmer, Sara J Deakyne Davies, Alexandria J Wiersma, Marcela Mendenhall, Joseph A Grubenhoff

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引用次数: 0

Abstract

Objectives: To investigate the relationship between language and diagnostic errors (DxE) in the pediatric emergency department (ED).

Methods: Electronic trigger identified ED encounters resulting in unplanned hospital admission that occurred within 10 days of an index visit from January 2018 through February 2022. Manual screening of each triggered encounter identified cases where the index visit diagnosis and hospitalization discharge diagnosis differed, and these were screened in for review using the Revised Safer Dx instrument to determine if a diagnostic error (DxE) occurred. Non-English primary language (NEPL) and English-proficient (EP) groups were established based on caregiver language. The primary outcome was the proportion of DxE each group. Data were analyzed using univariate analysis and multivariable logistic regression to identify independent predictors of DxE.

Results: Electronic trigger identified 3,551 patients, of which 806 (22.7 %) screened in for Safer Dx review. 172 (21.3 %) experienced DxE. The proportion of DxE was similar between EP and NEPL groups (21.5 vs. 21.7 %; p=0.97). Age≥12 years and fewer prior admissions in the preceding 6 months predicted higher odds of DxE. NEPL did not predict higher odds of DxE.

Conclusions: NEPL was not associated with increased odds DxE resulting in unplanned admission.

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儿科急诊科的首选语言和诊断错误。

目的：调查儿科急诊科（ED）语言与诊断错误（DxE）之间的关系。方法：从2018年1月到2022年2月，在指数就诊的10天内，电子触发识别的ED遭遇导致意外入院。对每一次触发的接触进行手动筛查，发现指数访视诊断和住院出院诊断不同的病例，并使用修订的更安全的Dx仪器对这些病例进行筛查，以确定是否发生了诊断错误（DxE）。非英语初级语言组（NEPL）和英语熟练组（EP）是根据照顾者的语言建立的。主要结果是各组DxE的比例。使用单变量分析和多变量逻辑回归对数据进行分析，以确定DxE的独立预测因素。结果：电子触发器识别了3551名患者，其中806名（22.7 %) 筛选以进行更安全的Dx审查。172（21.3 %) 经验丰富的DxE。EP组和NEPL组的DxE比例相似（21.5对21.7 %; p=0.97）。年龄≥12岁且在前6个月内入院次数较少预示着DxE的发生几率较高。NEPL不能预测更高的DxE发生几率。结论：NEPL与DxE增加导致意外入院的几率无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnosis MEDICINE, GENERAL & INTERNAL-

CiteScore

7.20

自引率

5.70%

发文量

期刊介绍： Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.　 Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error

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