The National Academy of Medicine defines 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. Simply put, these are diagnoses that are delayed, wrong or missed altogether.
The effects of diagnostic errors are currently estimated to affect upwards of 12 million Americans each year. Diagnostic errors cause more harm to patients than all other hospital errors combined. Analysis reveals that accurate and timely diagnosis depends nearly as much on the health care system as it does on the diagnosticians (providers) themselves.
Diagnostic errors also have a marked impact on health care providers, and the emotional effects of diagnostic error can be long-lasting and harmful. Patients identify the ramifications of diagnostic errors as emotional distress, prolonged illness and medical complications, impairment in activities of daily living, and decreased confidence in the health care system.
Given the prevalence and impacts of diagnostic errors, health care leaders must address them as part of their quality improvement and patient safety programs.
While there is no single cause of diagnostic error and therefore no single solution to the problem, this complex issue must be solved through systems improvement. In patient safety literature, several causes of diagnostic error were identified, including:
- Errors in clinical assessment and subsequent decision making
- Lack of time with the clinician
- Communication between clinicians and patients
- Communication between clinicians
- System failure
The Northwest Safety and Quality Partnership is helping to bring focus to diagnostic excellence as a quality measure by:
- Developing a three-part series provided by Kaiser Permanente subject matter experts with the goal to:
- Understand how and why diagnostic errors are made
- Identify what can be done to avoid diagnostic errors and improve the decision-making process
- Demonstrate the value of engaging and collaborating with patients and teammates
- Show the importance of documenting a differential diagnosis
- Share available resources and systems that support clinicians and patients in assuring diagnoses are timely, accurate and communicated efficiently