Understanding Diagnostic Error Patterns and Contributing Factors: A Descriptive Analysis of Medical Error Reports at a Tertiary Hospital in Kenya 2019-2021

Abstract

ABSTRACT Background Diagnostic errors in healthcare pose substantial risks, leading to increased costs, patient anxiety, and delayed diagnoses. Despite its prevalence, diagnostic errors have historically received less attention compared to other medical errors, necessitating urgent action to address these critical issues. This is more so in the low- and middle-income countries. (LMICs). This study aimed to analyze patterns and associated factors of diagnostic error reported to the Patient Safety Unit of Kenyatta National Hospital (KNH), a tertiary teaching hospital in Nairobi, Kenya. Methods This was a descriptive retrospective study of medical error reports(MER) forms submitted to KNH from 2019-2021.Type of medical errors, contributing factors, site, timing of error, and outcome were recorded. Descriptive statistics, chi-square tests, and logistic regression were employed to assess error types, contributing factors, and associated likelihoods. Results Among 640 MER forms analysed, diagnostic errors were reported in 40 percent of cases, predominantly associated with delayed diagnosis, wrong diagnosis, and failure to test. Contributing factors to MER included communication issues (36.1%), staff-related factors (48.9%), and equipment issues (15.6%). Diagnostic errors were more likely during non-working hours (OR 1.969, p < 0.047) and in Accident and Emergency department (OR 2.36, p < 0.022) within KNH. Conclusion Diagnostic errors represent a significant proportion of medical errors at KNH, particularly in Accident and Emergency settings. Strategies to involve more physicians in error reporting and enhance communication practices are recommended.