TABLE 6

Respondents' Ranking of Likely Effective Provider-Based and System-Based Solutions

Total (N = 727)Trainee (N = 291)Academic Pediatrician (N = 289)Community Pediatrician (N = 165)
n (%)Average Rankingn (%)Average Rankingn (%)Average Rankingn (%)Average Ranking
Provider-based solutions
    Close follow-up of patients to ensure that diagnosis is correct (rapid follow-up monitoring)532 (73)1.63202 (69)1.49193 (71)1.59137 (83)1.95
    Improving teamwork between members of health care team424 (58)1.19169 (58)1.23167 (62)1.2788 (53)0.99
    Increasing time spent in clinical encounters284 (39)0.79127 (44)0.9092 (34)0.6765 (39)0.76
    Empowering patients and families to be vigilant about possibility of diagnostic errors278 (38)0.66101 (35)0.60102 (38)0.6475 (45)0.78
    Asking for informal second opinions from same-specialty colleagues221 (30)0.5587 (30)0.5387 (32)0.6147 (28)0.51
    More training in clinical reasoning skills136 (19)0.3456 (19)0.3659 (22)0.3821 (13)0.25
System-based solutions
    Access to electronic medical records providing comprehensive patient data539 (74)1.75224 (77)1.84200 (74)1.76115 (70)1.59
    Diagnostic decision-support tools (Internet, electronic medical records, reference texts, or electronic support tools)425 (58)1.17171 (59)1.15159 (59)1.2295 (58)1.10
    Establishing feedback pathways to communicate changes in diagnoses to previous providers418 (57)1.10176 (60)1.21162 (60)1.1180 (48)0.92
    Increased access to and availability of consultants and experts321 (44)0.73104 (36)0.50115 (42)0.70102 (62)1.19
    Establishing peer review process for randomly selected patient records181 (25)0.4369 (24)0.4269 (25)0.4243 (26)0.47
  • The Friedman test showed significant differences among the ranked options (P < .0001).