Skip to main content

Currently Skimming:

Summary
Pages 1-18

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 1...
... • Medical record reviews suggest that diagnostic errors account for 6 to 17 percent of hospital adverse events. • Diagnostic errors are the leading type of paid medical malpractice claims, are almost twice as likely to have resulted in the patient's death compared to other claims, and represent the highest pro portion of total payments.
From page 2...
... Diagnostic errors may result in different outcomes, and as evidence accrues, these outcomes will be better characterized. For example, if there is a diagnostic error, a patient may or may not experience harm.
From page 3...
... FIGURE S-1  The diagnostic process. 3 Figures S-1 and 2-1 raster image, not editable broadside
From page 4...
... The definition employs a patient-centered perspective because patients bear the ultimate risk of harm from diagnostic errors. A diagnosis is not accurate if it differs from the true condition a patient has (or does not have)
From page 5...
... FIGURE S-3  The outcomes from the diagnostic process. 5 Figures S-3 and 3-1 raster image, not editable
From page 6...
... Some failures in the diagnostic process will lead to diagnostic errors; however, other failures in the diagnostic process will not ultimately lead to a diag­ nostic error, because subsequent steps in the process compensate for the initial failure. In this report, the committee describes "failures in the diagnostic process that do not lead to diagnostic errors" as near misses.
From page 7...
... Involving patients and their families in efforts to improve diagnosis is also critical because they have unique insights into the diagnostic process and the occurrence of diagnostic errors. The diagnostic process hinges on successful intra- and interprofessional collaboration among health care professionals, including primary care clinicians, physicians in various specialties, nurses, pharmacists, technologists, therapists, social workers, patient navigators, and many others.
From page 8...
... To accomplish this, they should: •  rovide patients with opportunities to learn about the diag P nostic process. •  reate environments in which patients and their families C are comfortable engaging in the diagnostic process and shar ing feedback and concerns about diagnostic errors and near misses.
From page 9...
... Proposed strategies to improve clinical reasoning include instruction and practice on generating and refining a differential diagnosis, generating illness scripts, developing an appreciation of how diagnostic errors occur and strategies to mitigate them, and engaging in metacognition and debiasing strategies. Oversight processes play a critical role in promoting competency in the diagnostic process.
From page 10...
... Recommendation 2b: Health care professional certification and ac creditation organizations should ensure that health care profes sionals have and maintain the competencies needed for effective performance in the diagnostic process, including the areas listed above. Ensure That Health Information Technologies Support Patients and Health Care Professionals in the Diagnostic Process Health IT has the potential to improve diagnosis and reduce diagnostic errors by facilitating timely and easy access to information; communication among health care professionals, patients, and their families; clinical reasoning; and feedback and follow-up in the diagnostic process.
From page 11...
... Develop and Deploy Approaches to Identify, Learn from, and Reduce Diagnostic Errors and Near Misses in Clinical Practice Due to the difficulty in identifying diagnostic errors and competing demands from existing quality and safety improvement priorities, very few health care organizations have processes in place to identify diagnostic errors and near misses. Nonetheless, identifying these experiences, learning from them, and implementing changes will improve diagnosis and reduce diagnostic errors.
From page 12...
... Recommendation 4b: Health care organizations should: •  onitor the diagnostic process and identify, learn from, and M reduce diagnostic errors and near misses as a component of their research, quality improvement, and patient safety programs. •  mplement procedures and practices to provide systematic I feedback on diagnostic performance to individual health care professionals, care teams, and clinical and organiza tional leaders.
From page 13...
... Organizational leadership can facilitate this culture, provide resources, and set priorities for achieving progress in diagnostic performance and reducing diagnostic errors. Health care organizations can also work to address diagnostic challenges related to fragmentation of the broader health care system.
From page 14...
... In addition, patients and their families are poorly served by the current system. While medical liability is broader than diagnosis, diagnostic errors are the leading type of paid medical malpractice claims.
From page 15...
... Improved collaboration between health professional liability insurance carriers and health care professionals and organizations could support education, training, and practice improvement strategies focused on improving diagnosis and minimizing diagnostic errors. Goal 6: Develop a reporting environment and medical liability system that facilitates improved diagnosis by learning from diagnostic errors and near misses Recommendation 6a: The Agency for Healthcare Research and Qual ity (AHRQ)
From page 16...
... payment has long been recognized for its inability to incentivize well-coordinated, high-quality, and efficient health care. There is limited information about the impact of payment and care delivery models on diagnosis, but it likely influences the diagnostic process and the occurrence of diagnostic errors.
From page 17...
... Provide Dedicated Funding for Research on the Diagnostic Process and Diagnostic Errors The diagnostic process and diagnostic errors have been neglected areas within the national research agenda; federal resources devoted to
From page 18...
... However, given the consistent lack of resources for research on diagnosis, and the potential for diagnostic errors to contribute to patient harm and health care costs, funding for this research is necessary for broader improvements to the quality and safety of health care. In addition, improving diagnosis could potentially lead to cost savings by preventing diagnostic errors, inappropriate treatment, and related adverse events.


This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.