Table 1.
Category of manifestations of error | Indicators of patient status | Indicators of clinical assessment | Indicators of clinical management |
---|---|---|---|
Patient deterioration | –Death* – Cardiorespiratory arrest* |
–Call code, rapid response or medical emergency team* –Transfer to higher level of care* –Unexpected emergent treatment (e.g. intubation, dialysis, procedure)* |
|
Unexpected time course of illness | – Ongoing symptoms necessitating representation to healthcare system* | –Prolonged hospitalization* –Shorter than expected length of stay –Treatment extended beyond normal duration –Readmission for related symptoms or condition* |
|
Change of management plan (recognition of error) | –Change in primary dx –Add, change, or remove secondary dx –Discrepancy between reason for admission and subsequent primary dx |
–Transfer to another hospital* –Change in primary service (Change of physician in charge*) –Abrupt starting or stopping multiple medications* –Change in procedure dx or type* |
|
Diagnostic uncertainty | – Symptom or findingbased primary dx | –Multiple consultations* –Multiple diagnostic procedures |
Note that these categories are not meant to be mutually exclusive, in that any single case of diagnostic error can ultimately manifest in any number of these potential outcomes. Those marked with an asterisk (*) were those we found as screening criteria in our review.