Pa Patient Saf Advis 2018 Oct 31;15(Suppl 1):70.
Improving Diagnosis: Action and Insights
Behavioral Healthcare, Critical Care, Emergency Medicine, Pathology, Radiology
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Rebecca Jones, MBA, BSN, RN, CPHRM, CPPS
Director, Innovation & Strategic Partnerships
Pennsylvania Patient Safety Authority

Actions and Insights

The articles in this special issue of the Pennsylvania Patient Safety Advisory offer a glimpse into the depth, breadth, and complexity of the diagnostic process.

From a discussion with subject matter experts about how to define the term diagnostic error to an analysis reflecting all potential failure points along the continuum of the diagnostic process, the content illustrates how some aspect of diagnosis is involved in nearly every healthcare encounter.

Theory and conceptual understanding of this topic are important, but they are not enough. Understanding must be translated into actions that lead to solutions to improve diagnosis and reduce harm and death from diagnostic error.

The following highlights from articles in this issue provide actions you can consider taking to improve diagnosis in your setting:

The opportunities are limitless. Become curious and seek to understand the vulnerabilities in your diagnostic processes. Trial small tests of change—you will gain insights by trying something new that you would not have gained by simply thinking about the problem.

Acknowledging that a concerted focus on this issue is long overdue, the Pennsylvania Patient Safety Authority recently launched the Center of Excellence for Improving Diagnosis (CoE) to catalyze awareness and action throughout Pennsylvania. Through our key objectives of knowledge, connection, and action, the CoE team will lead, guide, and support healthcare facilities and systems, providers, patients, and all interested stakeholders to improve diagnosis in Pennsylvania and beyond.

The desired future of a more accurate and timely diagnostic process begins with all of us.

Think of one way you can make a difference. Now do it.


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