Table 4.
Respondents’ ranking of most common contributory factors for diagnostic errors.
| Type of contributory Factors | Total (N = 200) | Nurses (N = 124) | Provider groups* (N = 76) | |||
|---|---|---|---|---|---|---|
| n (%) | Average ranking | n (%) | Average ranking | n (%) | Average ranking | |
| Types of factors involved | ||||||
| System-related errors | 125 (63) | 1.54 | 70 (56) | 1.44 | 55 (72) | 1.70 |
| Interplay of cognitive and system-related factors | 119 (60) | 1.10 | 65 (52) | 0.93 | 54 (71) | 1.38 |
| Cognitive errors | 99 (50) | 0.82 | 55 (44) | 0.75 | 44 (58) | 0.93 |
| No-fault errors | 71 (36) | 0.69 | 53 (43) | 0.81 | 18 (24) | 0.49 |
| System-related factors | ||||||
| Inadequate care coordination | 118 (59) | 1.43 | 68 (55) | 1.28 | 50 (66) | 1.67 |
| Personnel issues | 85 (43) | 0.89 | 55 (44) | 0.96 | 30 (39) | 0.78 |
| Cultural issues | 51 (26) | 0.42 | 26 (21) | 0.35 | 25 (33) | 0.54 |
| Technical problems | 48 (24) | 0.41 | 35 (28) | 0.47 | 13 (17) | 0.32 |
| Work environment issues | 32 (16) | 0.27 | 16 (13) | 0.23 | 25 (33) | 0.32 |
| Inadequate supervision | 27 (14) | 0.24 | 16 (13) | 0.22 | 11 (14) | 0.29 |
| Inadequate information systems | 26 (13) | 0.23 | 13 (10) | 0.18 | 13 (17) | 0.32 |
| Unavailability of subspecialist | 21 (11) | 0.17 | 10 (8) | 0.13 | 11 (14) | 0.25 |
| Unavailability of resources | 6 (3) | 0.05 | 4 (3) | 0.06 | 2 (2) | 0.03 |
| Cognitive factors involved | ||||||
| Inadequate data assessment | 106 (53) | 1.19 | 54 (44) | 0.85 | 52 (68) | 1.74 |
| Inadequate recognition of critical information | 108 (54) | 1.10 | 63 (51) | 1.10 | 45 (59) | 1.11 |
| Inadequate data gathering/work up | 93 (47) | 0.83 | 51 (41) | 0.77 | 42 (55) | 0.95 |
| Inadequate knowledge base | 71 (36) | 0.69 | 45 (36) | 0.75 | 26 (34) | 0.61 |
| Other factors involved | ||||||
| Focused on one diagnosis or treatment plan | 116 (58) | 1.46 | 63 (51) | 1.25 | 53 (51) | 1.80 |
| Misled by advice | 94 (47) | 0.92 | 51 (41) | 0.81 | 43 (57) | 1.08 |
| Misled by normal results | 79 (40) | 0.66 | 43 (35) | 0.56 | 43 (35) | 0.82 |
| Overconfidence about ability | 68 (34) | 0.59 | 40 (32) | 0.61 | 28 (32) | 0.55 |
| Having an attitude towards the patient | 21 (10) | 0.16 | 16 (13) | 0.21 | 5 (7) | 0.08 |
| Types of miscellaneous factors involved | ||||||
| Time/workload | 94 (47) | 0.95 | 54 (44) | 0.86 | 40 (53) | 1.11 |
| Provider inexperience | 65 (33) | 0.77 | 34 (27) | 0.62 | 31 (41) | 1.00 |
| Interruptions | 71 (36) | 0.70 | 35 (28) | 0.52 | 36 (47) | 1.01 |
| Parental pressure | 41 (21) | 0.45 | 30 (24) | 0.56 | 11 (14) | 0.26 |
| Health literacy | 42 (21) | 0.33 | 26 (21) | 0.33 | 16 (21) | 0.33 |
| Language barriers | 27 (14) | 0.26 | 15 (12) | 0.25 | 12 (16) | 0.26 |
| Provider over-reliance on memory | 24 (12) | 0.21 | 9 (7) | 0.15 | 15 (20) | 0.32 |
| Emotions affecting work | 8 (4) | 0.06 | 5 (4) | 0.07 | 3 (4) | 0.04 |
| Provider insensitivity | 6 (3) | 0.05 | 5 (4) | 0.07 | 1 (1) | 0.01 |
Friedman test showed significant differences among the ranked options between nurses and provider groups (p = ⩽0.001)
*
Includes medical doctors and advanced practice providers