Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 1;20(8):556-563.
doi: 10.1097/PTS.0000000000001283. Epub 2024 Sep 17.

Using Patient Experience Surveys to Identify Potential Diagnostic Safety Breakdowns: A Mixed Methods Study

Kelley M Baker  1 , Mark Brahier, Mara Penne, Mary A Hill, Siara Davis, William J Gallagher  2 , Kristen E Miller  3 , Kelly M Smith
Affiliations

Using Patient Experience Surveys to Identify Potential Diagnostic Safety Breakdowns: A Mixed Methods Study

Kelley M Baker et al. J Patient Saf. .

Abstract

Objectives: One in 20 outpatients in the United States experiences a diagnostic error each year, but there are no validated methods for collecting feedback from patients on diagnostic safety. We examined patient experience surveys to determine whether patients' free text comments indicated diagnostic breakdowns. Our objective was to evaluate associations between patient-perceived diagnostic breakdowns reported in free text comments and patients' responses to structured survey questions.

Methods: We conducted an exploratory mixed methods study using data from patient experience surveys collected from adult ambulatory care patients March 2020 to June 2020 in a large U.S. health system. Data analysis included content analysis of qualitative data and statistical analysis of quantitative data.

Results: In 2525 surveys with negative comments, 619 patients (24.5%) identified diagnostic breakdowns, including issues with accuracy (n = 282, 46%), timeliness (n = 243, 39%), or communication (n = 290, 47%); some patients (n = 181) reported breakdowns in multiple categories. Patients who gave a low average score (50 or less on a 100-point scale) on provider questions were almost seven times more likely to perceive a diagnostic breakdown than patients who scored their provider higher. Similarly, patients who gave a low average score on practice-related questions were twice as likely to perceive a diagnostic breakdown.

Conclusions: Patient feedback in routinely collected patient experience surveys is a valuable and actionable information source on diagnostic breakdowns in the ambulatory setting. The more easily monitored structured survey data provide a screening method to identify encounters that may have included a patient-perceived diagnostic breakdown and therefore require further examination.

PubMed Disclaimer

Conflict of interest statement

The authors disclose no conflict of interest.

Figures

FIGURE 1.
FIGURE 1.
Summary of study dataset.
See this image and copyright information in PMC

References

    1. The National Academies of Sciences, Engineering, and Medicine. Improving Diagnosis in Health Care. Washington, DC: National Academies Press; 2015:21794. - PubMed
    1. Singh H, Meyer AND, Thomas EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf. 2014;23:727–731. - PMC - PubMed
    1. Graber ML, Wachter RM, Cassel CK. Bringing diagnosis into the quality and safety equations. JAMA. 2012;308:1211–1212. - PubMed
    1. Agency for Healthcare Research and Quality. Measure Dx: A Resource to Identify, Analyze, and Learn from Diagnostic Safety Events. Rockville, MD: Agency for Healthcare Research and Quality; 2022.
    1. Agoritsas T, Bovier PA, Perneger TV. Patient reports of undesirable events during hospitalization. J Gen Intern Med. 2005;20:922–928. - PMC - PubMed