“It’s remarkable and gratifying. And it’s due time,” says Gordon Schiff, M.D., a leader in the movement to improve diagnosis, upon hearing that a leading health care improvement organization considers diagnostic error the number one patient safety concern in the country.
While Schiff and others at the Society to Improve Diagnosis in Medicine (SIDM) are deeply involved in researching ways to better understand and stem diagnostic error, they also see value in raising general awareness that missed, delayed and incorrect diagnoses can have a profound effect on patients’ health and lives.
The top-10 list, issued annually by ECRI Institute, a non-profit research and risk management firm, is widely anticipated, circulated and discussed in patient safety circles. The list gives visibility to new, evolving and perennial safety problems in patient care and helps organizations recognize, evaluate and prepare to improve them.
Gordon Schiff, MD, spoke at the Diagnostic Error in Medicine
conference in Boston in November 2017.
Schiff notes that where each patient safety concern ranks on the list is less important than the attention brought to many of the highly ranked issues: “They’re all important. And it’s interesting how many items on the list are interconnected with diagnostic error.” He points out that health information technology, number five on the list, plays a role both in supporting clinicians in the diagnostic process and contributing to errors. Other concerns – care coordination, health literacy and patient engagement – are also key to ensuring an accurate diagnosis.
Efforts to lessen the frequency of diagnostic error – estimated by the National Academy of Medicine to affect one in 20 Americans – and the harm it causes have expanded to include the study of how to improve the diagnostic process in general, not just prevent errors.
SIDM and a broad group of stakeholder organizations, the Coalition to Improve Diagnosis, are exploring, for example, how best to teach physicians to think through diagnostic challenges and to incorporate a range of clinicians – plus patients and family members – on the diagnostic team.