Taking Steps Towards a Safer Future: Measures to Promote Timely and Accurate Medical Diagnosis
Section snippets
Healthcare systems
Leaders of healthcare systems recognize the critical role their organizations play in promoting quality care and patient safety. Unfortunately, in the eyes of organization leaders, “patient safety” typically refers to injuries from falls, nosocomial infections, the “never” events, and medication errors. Healthcare leaders need to expand their concept of patient safety to include responsibility for diagnostic errors, an area they traditionally have been happy to relegate to their physicians.
Patients
Patients obviously have the appropriate motivation to help reduce diagnostic errors. They are perfectly positioned to prevent, detect, and mollify many system-based as well as cognitive factors that detract from timely and accurate diagnosis. Properly educated, patients are ideal partners to help reduce the likelihood of error. For patients to act effectively in this capacity, however, requires that physicians orient them appropriately and reformulate, to some extent, certain aspects of the
Other stakeholders
Oversight organizations such as the Joint Commission recently have entered the quest to reduce diagnostic error by requiring healthcare organizations to have reliable means to communicate test results. Healthcare organizations by necessity pay attention to Joint Commission expectations; these expectations should be expanded to include the many other organizational factors that have an impact on diagnostic error, such as encouraging feedback pathways and ensuring the consistent availability of
Conclusion
In summary, the faint blip of diagnostic error is finally growing stronger on the patient safety radar screen. An increasing number of publications are drawing attention to this issue. Research studies are starting to appear that use human factors approaches, observational techniques, or health services research protocols to better understand these errors and how to address them. In the proper order of things, our knowledge of diagnostic error will increase enough to suggest solutions, and
Author disclosures
Mark L. Graber, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer or provider of products discussed in this article.
Acknowledgements
This work was supported in part from a grant from the National Patient Safety Foundation. We are grateful to Eta Berner, EdD, for review of the manuscript and to Grace Garey and Mary Lou Glazer for their assistance.
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Statement of Author Disclosure: Please see the Author Disclosures section at the end of this article.
This research was supported by a grant from the National Patient Safety Foundation.