Roughly one in four patients who die in the intensive care unit (ICU) do so with a misdiagnosis, according to data analyzed by a group from the Johns Hopkins University of Medicine. 
The group further estimated that 40,500 adults die in American ICUs each year with misdiagnoses, and in 8% of those cases, the misdiagnosis was the cause of death. The findings were published in the latest issue of BMJ Quality & Safety. “The bottom line is that these were misdiagnoses made by the ICU staff,” the study’s lead author Bradford Winters, MD, associate professor of anesthesiology and critical care medicine at Johns Hopkins University School of Medicine, told HealthLeaders Media. “We hope this article is a wake-up call so people realize the impact this has.” The four most common misdiagnoses (heart attack, pneumonia, aspergillosis, and pulmonary embolism) account for one-third of missed diagnoses. Missed diagnoses can also lead to extended stays and poor quality of care for patients who do not die in the ICU. Winters says improvements in technology and equipment may help diagnose these conditions, but those solutions are not yet available to acute care providers. In the meantime, he suggests hospitals employ an intensivist to monitor the ICU. But with only 7,000 board certified intensivists in the US, there is not nearly enough to be in every hospital. The shortage of intensivists may make it difficult for ICU managers to hire one for their department. The process could take several months or even years. In some cases, a hospital may never find a permanent doctor. At Barton Associates we have invested time and resources into developing a network of board certified locum tenens intensivists who can step in to help hospital ICUs improve their ability to diagnose patients. Hospitals should consider using locum tenens intensivists to manage their ICU until they can find the ideal permanent employee. Doing so will ensure patients are properly diagnosed and treated.
The group further estimated that 40,500 adults die in American ICUs each year with misdiagnoses, and in 8% of those cases, the misdiagnosis was the cause of death. The findings were published in the latest issue of BMJ Quality & Safety. “The bottom line is that these were misdiagnoses made by the ICU staff,” the study’s lead author Bradford Winters, MD, associate professor of anesthesiology and critical care medicine at Johns Hopkins University School of Medicine, told HealthLeaders Media. “We hope this article is a wake-up call so people realize the impact this has.” The four most common misdiagnoses (heart attack, pneumonia, aspergillosis, and pulmonary embolism) account for one-third of missed diagnoses. Missed diagnoses can also lead to extended stays and poor quality of care for patients who do not die in the ICU. Winters says improvements in technology and equipment may help diagnose these conditions, but those solutions are not yet available to acute care providers. In the meantime, he suggests hospitals employ an intensivist to monitor the ICU. But with only 7,000 board certified intensivists in the US, there is not nearly enough to be in every hospital. The shortage of intensivists may make it difficult for ICU managers to hire one for their department. The process could take several months or even years. In some cases, a hospital may never find a permanent doctor. At Barton Associates we have invested time and resources into developing a network of board certified locum tenens intensivists who can step in to help hospital ICUs improve their ability to diagnose patients. Hospitals should consider using locum tenens intensivists to manage their ICU until they can find the ideal permanent employee. Doing so will ensure patients are properly diagnosed and treated.
