Abstract
To determine the frequency and etiology of diagnostic errors during the first 7 days of admission for inborn neonatal intensive care unit (NICU) patients. We conducted a retrospective cohort study of 600 consecutive inborn admissions. A physician used the "Safer Dx NICU Instrument" to review the electronic health record for the first 7 days of admission, and categorized cases as "yes," "unclear," or "no" for diagnostic error. A secondary reviewer evaluated all "yes" charts plus a random sample of charts in the other categories. Subsequently, all secondary reviewers reviewed records with discordance between primary and secondary review to arrive at consensus. We identified 37 diagnostic errors (6.2% of study patients) with "substantial agreement" between reviewers (κ = 0.66). The most common diagnostic process breakdown was missed maternal history (51%). The frequency of diagnostic error in inborn NICU patients during the first 7 days of admission is 6.2%.
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