Improving Diagnosis in Health Care

When providing health care to patients, it is crucial to get the proper diagnosis as soon as possible to help the patient make the best decisions for their health and long-term goals. Recognizing that diagnostic errors have been around for decades, affecting the accuracy of patient diagnoses, the National Academies of Sciences, Engineering, and Medicine convened a committee of experts to research and better understand how diagnostic errors occur and to propose recommendations on how to improve patient diagnosis.

The committee defined diagnostic error as “the failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient.” The committee determined that while diagnostic errors stem from a variety of causes, the definition of diagnostic error should be defined from the patient’s perspective because they hold the ultimate risk of harm from diagnostic errors.

The committee understood that since diagnostic errors stem from multiple causes, a singular, narrow focus on reducing diagnostic errors would not achieve the extensive change the committee believes to be necessary. Instead, the committee developed a conceptual model to better articulate the diagnostic process and to identify eight goals to reduce diagnostic error and improve diagnosis.

Those eight goals centered around the importance of the continuous improvement of teamwork, education and training, technology, and research. For example, one particular goal was to enhance healthcare education and training in the diagnostic process. “Getting the right diagnosis depends on all health care professionals involved in the diagnostic process receiving appropriate education and training,” the article stated. “Improved emphasis on diagnostic competencies and feedback on diagnostic performance are needed.” Education to improve diagnoses is especially important as health care delivery has gotten increasingly complex, the authors note.

The committee concluded with a reminder that nearly everyone has a responsibility in working to reduce diagnostic error: “just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers.”

In addition to the recommendations made to physicians, the National Academies of Sciences, Engineering, and Medicine also put out a pamphlet geared toward patients. The pamphlet’s purpose is to help patients better understand how diagnostic errors occur and what they, as the ultimate risk-bearers of diagnostic error, can do to avoid them. The pamphlet emphasizes how important effective communication and collaboration with medical providers is. It provides a checklist for patients to ensure that they are doing their part in communicating with their medical professionals, including items like: be clear, complete and accurate when describing their illness; keep track of helpful treatments; and keep good medical records.

Overall, there are many factors that contribute to diagnostic error, and many possible solutions that have the potential to reduce the number of misdiagnosed patients. Effective education, collaboration, and continuous improvement are key components of the solution. 

 

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