Document Type

Article

Publication Date

8-26-2021

Identifier

DOI: 10.1515/dx-2020-0032

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.

Journal Title

Diagnosis (Berl)

Volume

8

Issue

3

First Page

347

Last Page

352

Keywords

antimicrobial stewardship; diagnostic error; patient safety; pediatrics

Comments

This work is licensed under the Creative Commons Attribution 4.0 International License.

Publisher's Link: https://www.degruyter.com/document/doi/10.1515/dx-2020-0032/html

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