Diagnostic Time-Outs to Improve Diagnosis

Sarah Yale; Susan Cohen; Brett J Bordini

doi:10.1016/j.ccc.2021.11.008

Diagnostic Time-Outs to Improve Diagnosis

Crit Care Clin. 2022 Apr;38(2):185-194. doi: 10.1016/j.ccc.2021.11.008.

Authors

Sarah Yale¹, Susan Cohen², Brett J Bordini³

Affiliations

¹ Division of Hospital Medicine, Medical College of Wisconsin, Children's Corporate Center, Suite 560, 999 North 92nd Street, Milwaukee, WI 53226, USA. Electronic address: syale@mcw.edu.
² Division of Neonatology, Medical College of Wisconsin, Children's Corporate Center, Suite 410, 999 North 92nd Street, Milwaukee, WI 53226, USA.
³ Division of Hospital Medicine, Medical College of Wisconsin, Children's Corporate Center, Suite 560, 999 North 92nd Street, Milwaukee, WI 53226, USA.

PMID: 35369942
DOI: 10.1016/j.ccc.2021.11.008

Abstract

Diagnostic errors harm patients. While the underlying causes of diagnostic error and the settings in which they occur are diverse, the use of a cognitive forcing function in the form of a diagnostic time-out can mitigate the risk of diagnostic error. Barriers to the implementation of diagnostic time-outs remain. In our survey of neonatal intensive care unit (NICU) providers, perceived time constraints were universally cited as a barrier. Attending neonatologists and neonatology nurse practitioners reported decreased perception of the risk of diagnostic error impacting patient outcomes, relative to the perception among neonatology fellowship trainees. Future directions include addressing concerns over the perceived time investment required for a diagnostic time-out and increasing provider appreciation of the nature and impact of diagnostic error on patient outcomes.

Keywords: Cognitive bias; Diagnostic error; Diagnostic time-out.

Publication types

Review

MeSH terms

Cognition*
Diagnostic Errors / prevention & control
Humans
Infant, Newborn
Intensive Care Units, Neonatal*