title: Diagnostic Delays and Errors in Head and Neck Cancer Patients: Opportunities for Improvement.
abstract: A retrospective review of 100 sequential patients (2009-2012) with head and neck cancer was performed to determine the frequency of 5 types of diagnostic delays and errors outlined by the Institute of Medicine. There were a total of 105 diagnostic delays/errors. The most common was delay in being seen in the otolaryngology clinic after referral placement (28.6%), followed by diagnostic error by the referring physician (22%), delay in referral of a symptomatic patient to the otolaryngology clinic (16.2%), delay in employing an appropriate diagnostic test or procedure (15.2%), delay in action following reporting of pathology or imaging results for an incidental lesion (11.4%), diagnostic error by the otolaryngology clinic (2.8%), delay in action following reporting of pathology or imaging results for the symptomatic lesion (2.8%), and use of outmoded tests or therapy (1%). Increased awareness of these types of delays/errors will direct actions and processes to reduce or eliminate them.
authors.affiliation: 1 Saint Louis University School of Medicine, St Louis, MO.
authors.forename: Joel
authors.initials: J
authors.lastname: Franco
authors.affiliation: 2 Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Alhasan N
authors.initials: AN
authors.lastname: Elghouche
authors.affiliation: 2 Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Harris
authors.affiliation: 3 Aurora Health Care, Milwaukee, WI.
authors.forename: Mimi S
authors.initials: MS
authors.lastname: Kokoska
mesh_terms: D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D010036:Otolaryngology / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: delayed diagnosis; diagnostic error; head and neck neoplasms; patient safety; quality improvement