Patients' Experiences of Dental Diagnostic Failures: A Qualitative Study Using Social Media.


Journal

Journal of patient safety
ISSN: 1549-8425
Titre abrégé: J Patient Saf
Pays: United States
ID NLM: 101233393

Informations de publication

Date de publication:
12 Feb 2024
Historique:
medline: 12 2 2024
pubmed: 12 2 2024
entrez: 12 2 2024
Statut: aheadofprint

Résumé

Despite the many advancements made in patient safety over the past decade, combating diagnostic errors (DEs) remains a crucial, yet understudied initiative toward improvement. This study sought to understand the perception of dental patients who have experienced a dental diagnostic failure (DDF) and to identify patient-centered strategies to help reduce future occurrences of DDF. Through social media recruitment, we conducted a screening survey, initial assessment, and 67 individual patient interviews to capture the effects of misdiagnosis, missed diagnosis, or delayed diagnosis on patient lives. Audio recordings of patient interviews were transcribed, and a hybrid thematic analysis approach was used to capture details about 4 main domains of interest: the patient's DDF experience, contributing factors, impact, and strategies to mitigate future occurrences. Dental patients endured prolonged suffering, disease progression, unnecessary treatments, and the development of new symptoms as a result of experiencing DE. Poor provider communication, inadequate time with provider, and lack of patient self-advocacy and health literacy were among the top attributes patients believed contributed to the development of a DE. Patients suggested that improvements in provider chairside manners, more detailed patient diagnostic workups, and improving personal self-advocacy; along with enhanced reporting systems, could help mitigate future DE. This study demonstrates the valuable insight the patient perspective provides in understanding DEs, therefore aiding the development of strategies to help reduce the occurrences of future DDF events. Given the challenges patients expressed, there is a significant need to create an accessible reporting system that fosters constructive clinician learning.

Identifiants

pubmed: 38345377
doi: 10.1097/PTS.0000000000001198
pii: 01209203-990000000-00191
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

The authors disclose no conflict of interest.

Références

Institute of Medicine (US), Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, eds. To Err Is Human: Building a Safer Health System. Washington, DC: National Academies Press (US); 2000. doi: 10.17226/9728.
Shafer G, Gautham KS. Diagnostic Error. Crit Care Clin. 2022;38:1–10.
The National Academies of Sciences, Engineering, and Medicine, Committee on Diagnostic Error in Health Care; Board on Health Care Services; Balogh EP, Miller BT, Ball JR, eds. Improving Diagnosis in Health Care. Washington, DC: National Academies Press (US); 2015. doi: 10.17226/21794.
Leape LL, Berwick DM, Bates DW. Counting deaths due to medical errors—reply. JAMA. 2002;288:2405.
Saber Tehrani AS, Lee H, Mathews SC, et al. 25-Year summary of US malpractice claims for diagnostic errors 1986–2010: an analysis from the National Practitioner Data Bank. BMJ Qual Saf. 2013;22:672–680.
Ball JR, Balogh E. Improving diagnosis in health care: highlights of a report from the National Academies of Sciences, Engineering, and Medicine. Ann Intern Med. 2016;164:59–61.
Obadan EM, Ramoni RB, Kalenderian E. Lessons learned from dental patient safety case reports. J Am Dent Assoc. 2015;146:318–326.e2.
Pitiphat W, Diehl SR, Laskaris G, et al. Factors associated with delay in the diagnosis of oral cancer. J Dent Res. 2002;81:192–197.
Schnetler JFC. Oral cancer diagnosis and delays in referral. Br J Oral Maxillofac Surg. 1992;30:210–213.
Tokede O, White J, Stark PC, et al. Assessing use of a standardized dental diagnostic terminology in an electronic health record. J Dent Educ. 2013;77:24–36.
Sabih DE, Sabih A, Sabih Q, et al. Image perception and interpretation of abnormalities; can we believe our eyes? Can we do something about it? Insights Imaging. 2011;2:47–55.
Isabel Healthcare. You Gov survey of medical misdiagnosis [Isabel Healthcare web site]. October 5, 2017. Available at: https://info.isabelhealthcare.com/blog/60-million-us-adults-say-they-have-experienced-a-misdiagnosis-isabel-healthcare. Accessed June 26, 2023.
Schiff GD, Hasan O, Kim S, et al. Diagnostic error in medicine: analysis of 583 physician-reported errors. Arch Intern Med. 2009;169:1881–1887.
Perrem LM, Fanshawe TR, Sharif F, et al. A national physician survey of diagnostic error in paediatrics. Eur J Pediatr. 2016;175:1387–1392.
Graber ML, Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med. 2005;165:1493.
Swain J. A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example. Thousand Oaks, CA: SAGE Publications Ltd; 2018. doi:10.4135/9781526435477.
Manski R, Moeller J, Chen H, et al. Disparity in dental coverage among older adult populations: a comparative analysis across selected European countries and the USA. Int Dent J. 2015;65:77–88.
Wei L, Griffin SO, Parker M, et al. Dental health status, use, and insurance coverage among adults with chronic conditions: implications for medical-dental integration in the United States. J Am Dent Assoc. 2022;153:563–571.e2.
Naavaal S, Barker LK, Griffin SO. The effect of health and dental insurance on US children’s dental care utilization for urgent and non-urgent dental problems—2008. J Public Health Dent. 2017;77:54–62.
Ozkaya A, Garip R, Nur Tarakcioglu H, et al. Clinical and imaging findings of pattern dystrophy subtypes; diagnostic errors and unnecessary treatment in clinical practice. J Fr Ophtalmol. 2018;41:21–29.
Suhocki PV, Meyers WC. Injury to aberrant bile ducts during cholecystectomy: a common cause of diagnostic error and treatment delay. Am J Roentgenol. 1999;172:955–959.
Dental Patient Safety Foundation [database online]. Orland Park, IL; 2017: Updated 2023.
Welcome to NRLS Reporting [NRLS web site]. Available at: https://report.nrls.nhs.uk/nrlsreporting/. Accessed June 26, 2023.
Thusu S, Panesar S, Bedi R. Patient safety in dentistry—state of play as revealed by a national database of errors. Br Dent J. 2012;213:E3–E3.
Bagley CH, Panesar SS, Patel B, et al. Safer cut: revelations of surgical harm through a national database. Br J Hosp Med. 2010;71:484–485.
HEDIS and Performance Measurement [NCQA web site]. Available at: https://www.ncqa.org/hedis/. Accessed June 26, 2023.
Wolf ZR, Serembus JF. Medication errors: ending the blame-game. Nurs Manage. 2004;35:41–48, 44, 47–48.
Pierluissi E. Discussion of medical errors in morbidity and mortality conferences. JAMA. 2003;290:2838.

Auteurs

Enihomo Obadan-Udoh (E)

From the UC San Francisco Department of Preventive and Restorative Dental Sciences, San Francisco.

Rachel Howard (R)

From the UC San Francisco Department of Preventive and Restorative Dental Sciences, San Francisco.

Luke Carmichael Valmadrid (LC)

UC San Diego School of Medicine, San Diego, California.

Muhammad Walji (M)

UT Health Houston School of Dentistry, Houston, Texas.

Classifications MeSH