The next phase of patient safety improvement: Tackling misdiagnosis

The healthcare industry must adopt a systemwide approach to tackling medical misdiagnosis, a growing concern due to recent research that estimates 12 million people in the United States will experience a diagnostic error each year, argues an opinion piece published in the New England Journal of Medicine.

"Diagnostic error may involve any of various types of overlapping missed opportunities to make a correct and timely diagnosis," write Hardeep Singh, M.D., and Mark L. Graber, M.D., of the RTI International in Raleigh-Durham, North Carolina. "A diagnosis may be missed completely, the wrong one may be provided, or diagnosis may be delayed, all of which can lead to harm from delayed or inappropriate treatments and tests."

A report issued by the Institute of Medicine (IOM) in September said that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.

To reduce diagnostic errors, Singh and Graber recommended that healthcare institutions and providers follow the suggestions in the IOM report, which include efforts to:

  • Ensure health information technology supports the diagnostic process
  • Strengthen teamwork
  • Measure and learn from errors
  • Promote a culture of diagnostic safety
  • Increase research funding
  • Promote a culture of diagnostic safety

But they also recommend that patients and practicing clinicians work together to generate solutions to reduce misdiagnosis. 

"Doctors now have high rates of burnout due to administrative burdens, user-unfriendly electronic records, productivity pressures and reimbursement systems that don't support listening to patients and putting their stories together," Singh said in an announcement. "We need to change situations that increase our risk of missing important patient symptoms."

Patient safety experts reviewed the IOM recommendations earlier this year and concluded that they represent a turning point in overcoming medical misdiagnoses and their consequences for patients and care providers. 

The IOM report was the third in a series that began in 2000 with To Err is Human: Building a Safer Health System and continued in 2001 with Crossing the Quality Chasm: A New Health System for the 21st Century. This was the first study of its kind to specifically target diagnostic errors in the healthcare setting.

To learn more:
- read the opinion piece
- here's the announcement

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