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1 Introduction
Pages 19-30

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From page 19...
... Absent a spotlight to illu­ inate this critical challenge, diagnostic errors have been largely un­ m appreciated within the quality and patient safety movements. The result of this inattention is significant: It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.
From page 20...
... The widespread challenge of diagnostic errors frequently rises to broad public attention, whether the widely reported diagnostic error of Ebola virus infection in a Dallas hospital emergency department or in the occasional report of an extraordinarily high malpractice award for failure to make a timely diagnosis of cancer or some other life threatening disease (Pfeifer, 2015; Upadhyay et al., 2014; Wachter, 2014)
From page 21...
... . This difficulty in identifying the etiology of errors, combined with a lack of feedback on diagnostic performance in many health care settings, limits understanding and makes it more difficult to prioritize improving diagnosis and reducing diagnostic errors.
From page 22...
... This report by the Committee on Diagnostic Error in Health Care synthesizes current knowledge about diagnostic error and makes recommendations on how to reduce diagnostic errors and improve diagnosis. CONTEXT OF THE STUDY This study is a continuation of the IOM Quality Chasm Series, which focuses on assessing and improving the quality and safety of health care.
From page 23...
... With support from a broad coalition of sponsors -- the Agency for Healthcare Research and Quality, the American College of Radiology, the American Society for Clinical Pathology, the Cautious Patient Foundation, the Centers for Disease Control and Prevention, the College of American Pathologists, The Doctors Company Foundation, Janet and Barry Lang, Kaiser Permanente National Community Benefit Fund at the East Bay Community Foundation, and the Robert Wood Johnson Foundation -- the study began in January 2014. An independent committee was appointed with a broad range of expertise, including diagnostic error, patient safety, health care quality and measurement, patient engagement, health policy, health care professional education, cognitive psychology, health disparities, human factors and e ­ rgonomics, health information technology (health IT)
From page 24...
... CONCEPTUAL MODEL To help frame and organize its work, the committee developed a conceptual model that defined diagnostic error and also illustrated the diag­ nostic process, the work system in which the diagnostic process occurs, and the outcomes that result from this process (see Chapters 2 and 3 for detailed information on the conceptual model)
From page 25...
... Jeff cited the willingness of his clinicians to listen to him and his wife and to continue investigating his symptoms despite his normal EKG results as major contributors to his rapid diagnosis. Because aortic dissections are life-threatening events that require urgent treatment, the quick action of the ED to get Jeff to surgery also contributed to the successful outcome.
From page 26...
... . Appendix D includes additional examples of diagnostic error in order to convey a broader sense of the types of diagnostic errors that can occur.
From page 27...
... Section II, or Chapters 4 through 8, describes the challenges of diagnosis and is organized by the elements of the work system: Chapter 4 discusses the diagnostic team members and the tasks they perform in the diagnostic process; Chapter 5 discusses the technologies and tools (specifically health IT) used in the diagnostic process; Chapter 6 focuses on health care organizations and their impact on the diagnostic process and diagnostic error; Chapter 7 describes the external elements that influence diagnosis, including payment and care delivery, reporting, and medical liability; and Chapter 8 highlights the
From page 28...
... :1803–1804. Betsy Lehman Center for Patient Safety and Medical Error Reduction.
From page 29...
... 2009. Diagnostic errors -- The next frontier for patient safety.
From page 30...
... 2014. Editorial: Helping health care organizations to define diagnostic errors as missed opportunities in diagnosis.


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