Feasibility and Perceived Value of a Team Diagnostic Timeout: A Multi-Institutional Pilot Study

OBJECTIVE To describe the feasibility and perceived value of a diagnostic timeout (DT) across a national pediatric learning network. METHODS The DT was implemented during unplanned transfers from general care to the pediatric intensive care unit (PICU) from April 2024 through June 2024 at 4 children’s hospitals. One health care team member filled out a survey immediately after the DT to assess participant roles, the time required, and the perceived value. Responses were stratified by which team members participated and compared using chi-square tests. RESULTS Overall, a DT was performed in 43% (78 of 182) of unplanned transfers with notable heterogeneity in its use across sites (site A, 75% [18 of 24]; site B, 56% [22 of 39]; site C, 53% [36 of 68]; site D, 4% [2 of 51]). Over 90% of DTs took 5 minutes or less. The value statement “Improved interdisciplinary team understanding of the priorities and plan of care” received the highest number of “Agree/Strongly Agree” responses (47%; 37 of 78), and the statement “Changed or added to the differential diagnosis” received the fewest (28%; 22 of 78). There was a statistically higher percentage of “Agree/Strongly Agree” responses to most survey statements when the bedside nurse or patient and/or family were present. CONCLUSIONS The adoption of a DT during unplanned PICU transfers varied considerably across sites but was feasible in under 5 minutes. The perceived value was greatest when the patient and/or family or bedside nurse were present. Future studies are needed to better understand how best to implement a DT and how it impacts diagnostic error.