Collaboration, patient engagement could reduce diagnostic errors

Research

Diagnostic errors are an industry-wide problem but there are several steps hospitals can take to prevent them. 

Hardeep Singh, M.D., and Laura Zwaan, Ph.D., of Baylor College of Medicine, investigated misdiagnosis in hospitalized patients and identified improvement opportunities in five major steps of the diagnosis process, according to the Annals of Internal Medicine. These include:

  • The patient-physician encounter, during which caregivers can develop communication skills to aid patients more effectively, improve both knowledge and clinical reasoning, and, in cases of uncertainty, develop “cognitive support,” in which they seek decision support from online resources or colleagues.
  • Testing and results interpretation, during which clinicians can collaborate with diagnostic specialists to make sure the testing strategy used is the most precise method possible. Face-to-face communication wherever possible at this stage is crucial in case results are difficult to interpret.
  • Follow-up/monitoring of developing diagnostic information: During this step, clinicians should use information technology such as electronic alerts to make sure they follow-up on all test results pending at discharge, as well as keep track of any pre-hospitalization diagnostic data.
  • Coordination/communication with subspecialties: This should involve direct communication to hand down critical decisions, rather than consulting charts after the fact.
  • Patient-focused strategies, during which clinicians should re-evaluate diagnoses together in case of multiple consultants, engage patients to make sure they understand the post-discharge process and encourage patients and their families’ participation in the diagnostic process.

The report comes a little over a year after a report from the Institute of Medicine outlined eight paths to improved healthcare diagnosis, a follow-up to the Institute’s 1999 report “To Err is Human.” Paul Epner, chairman of the Coalition to Improve Diagnosis, told FierceHealthcare at the time he was hopeful the report signaled a broader movement toward eliminating errors across the country.