Why providers need to consider patient perspective when addressing diagnostic errors

Doctor with patient
Providers need to listen to patients when seeking solutions to address diagnostic errors. (Getty/wutwhanfoto)

Diagnostic errors are a significant contributor to patient harm. To address the problem, providers need to spend more time listening to patients’ experiences, according to a new study.

Researchers examined data from 465 patients who reported a diagnostic error between January 2010 and February 2016. From those reports, they identified 184 different “narratives” for how patients experienced those errors.

These narratives, according to the researchers, can flag areas providers should target in patient safety efforts. 

“We really encourage bringing patients into the discussion on patient safety,” lead study author Traber Davis Giardina, Ph.D., a postdoctoral fellow at the Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center, said at a briefing last week. “Their experiences really have so much to offer.” 

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The researchers estimate that 12 million people are impacted by a diagnostic error each year, accounting for between 6% and 17% of adverse events for inpatients. That provides a large database to use to identify potential ways to address the problem—but, such errors are also underreported.

The study suggests that current reporting systems don’t work for patients, or patients perceive that they don’t work. More than half of the participants said they reported the diagnostic error, but just 9% were satisfied with the response from the providers.

The study also identified 224 instances where patients said clinicians ignored their knowledge, disrespected or mocked them, failed to provide complete and timely information or manipulated or deceived them, which can also hinder reporting.

These findings have implications for medical training and current processes, the researchers said.

Gathering data from patients should be built into safety programs. Vanderbilt, for example, codes patient and family complaints into its records.

“Patients’ experiences can supplement existing report systems,” Giardina said.

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Policymakers at the national level should consider new initiatives, such as accreditation programs, that incentivize this data gathering.

Issues with communication should be addressed by updating medical curricula and by offering continuing education, according to the study. Communication training can help doctors provide information to patients in a way that’s most useful and can also mitigate their expectations.

Professionalism and bedside manner should also be a piece of these training protocols, according to the study.