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. 2020 Oct 28;8(3):347-352.
doi: 10.1515/dx-2020-0032. Print 2021 Aug 26.

Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors

Justin B Searns  1 , Manon C Williams  2 , Christine E MacBrayne  3 , Ann L Wirtz  4 , Jan E Leonard  5 , Juri Boguniewicz  2 , Sarah K Parker  2 , Joseph A Grubenhoff  5
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Free article

Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors

Justin B Searns et al. Diagnosis (Berl). .
Free article

Abstract

Objectives: Few studies describe the impact of antimicrobial stewardship programs (ASPs) on recognizing and preventing diagnostic errors. Handshake stewardship (HS-ASP) is a novel ASP model that prospectively reviews hospital-wide antimicrobial usage with recommendations made in person to treatment teams. The purpose of this study was to determine if HS-ASP could identify and intervene on potential diagnostic errors for children hospitalized at a quaternary care children's hospital.

Methods: Previously self-identified "Great Catch" (GC) interventions by the Children's Hospital Colorado HS-ASP team from 10/2014 through 5/2018 were retrospectively reviewed. Each GC was categorized based on the types of recommendations from HS-ASP, including if any diagnostic recommendations were made to the treatment team. Each GC was independently scored using the "Safer Dx Instrument" to determine presence of diagnostic error based on a previously determined cut-off score of ≤1.50. Interrater reliability for the instrument was measured using a randomized subset of one third of GCs.

Results: During the study period, there were 162 GC interventions. Of these, 65 (40%) included diagnostic recommendations by HS-ASP and 19 (12%) had a Safer Dx Score of ≤1.50, (Κ=0.44; moderate agreement). Of those GCs associated with diagnostic errors, the HS-ASP team made a diagnostic recommendation to the primary treatment team 95% of the time.

Conclusions: Handshake stewardship has the potential to identify and intervene on diagnostic errors for hospitalized children.

Keywords: antimicrobial stewardship; diagnostic error; patient safety; pediatrics.

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References

    1. Okafor, N, Payne, VL, Chathampally, Y, Miller, S, Doshi, P, Singh, H. Using voluntary reports from physicians to learn from diagnostic errors in emergency medicine. Emerg Med J 2016;33:245–52. https://doi.org/10.1136/emermed-2014-204604.
    1. Kohn, LT, Corrigan, J, Donaldson, MS. To err is human: building a safer health system. Washington, DC: National Academy Press; 2000, vol xxi:287.
    1. Singh, H, Thomas, EJ, Wilson, L, Kelly, PA, Pietz, K, Elkeeb, D, et al. Errors of diagnosis in pediatric practice: a multisite survey. Pediatrics 2010;126:70–9. https://doi.org/10.1542/peds.2009-3218.
    1. Rinke, ML, Singh, H, Ruberman, S, Adelman, J, Choi, SJ, O’Donnell, H, et al. Primary care pediatricians’ interest in diagnostic error reduction. Diagnosis (Berl) 2016;3:65–9. https://doi.org/10.1515/dx-2015-0033.
    1. Grubenhoff, JA, Ziniel, SI, Cifra, CL, Singhal, G, McClead, RE, Singh, H. Pediatric clinician comfort discussing diagnostic errors for improving patient safety: a survey. Pediatr Qual Saf 2020;5:e259. https://doi.org/10.1097/pq9.0000000000000259.

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