Improving Diagnosis in Health Care
Getting the right diagnosis is a key aspect of health care: it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. National Academies of Sciences, Engineering, and Medicine. 2015. Improving Diagnosis in Health Care. Washington, DC: The National Academies Press.
Recommendations for Improving Diagnosis in Health Care—Institute of Medicine
The Institute of Medicine provides eight goals to improve diagnosis in healthcare including facilitating more effective teamwork among health care professionals, patients, and their families; and enhancing health care professional education and training in the diagnostic process.
Improving Diagnostic Quality & Safety/Reducing Diagnostic Error: Measurement Considerations
The Diagnostic Process and Outcomes domain of the Framework addresses the actions and processes that are carried out by healthcare providers and/or teams to develop, refine, and confirm a diagnosis, or to explain the patient's health problem. The updated environmental scan identified several articles that add additional breadth to some subdomains, describing additional interventions and approaches that may be useful in reducing diagnostic error.
Serious misdiagnosis-related harms in malpractice claims: The "Big Three"—vascular events, infections, and cancers
The "Big Three" diseases—vascular events, infections, and cancers—account for about three-fourths of serious misdiagnosis-related harms. Initial efforts to improve diagnosis should focus on vascular events, infections, and cancers.
The new diagnostic team. 2017.
This article discusses an expanded diagnostic team—including nurses and allied health professionals, as well as the patient—that supports the diagnostic process.
Patient involvement strategies for diagnostic error mitigation. 2013.
This article contains a list of patient tactics for preventing and detecting diagnostic errors, including telling your story well, being an informed patient, and ensuring follow-up on testing. The authors encourage patients to report diagnostic error.
Defining the role of nurses in diagnostic error prevention. 2017
Patient's toolkit for diagnosis. 2015.
This toolkit helps patients prepare for a visit with their healthcare provider by providing a format with prompts for telling their story clearly.
Beyond the lab: the link between health IT and laboratory testing. 2018.
This article presents risk reduction strategies including assembling a multidisciplinary team to evaluate and improve the total testing process, simplifying test names in order menus, monitoring the display of results, and establishing a communication plan for incomplete specimens, cancelled specimens, and amended results.
Clinical reasoning toolkit. [accessed 2018].
This toolkit shares resources as an introduction to clinical reasoning.
Patient flow in the ED - diagnostic evaluation through disposition decision. 2015.
This article includes general principles to enhance patient safety related to the diagnostic process in the ED setting.
Patient flow in the ED - after disposition through departure. 2015.
This article includes strategies to enhance patient safety related to monitoring, communication, and a reference from the Agency for Healthcare Research and Quality on a feedback mechanism about a patient's ED diagnosis versus final diagnosis.