Frontline Strategies to Reduce Misdiagnosis in Hospitalized Patients

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Researchers from Baylor College of Medicine, the Michael E. DeBakey Veterans Affairs Medical Center, and the Institute of Medical Education Research Rotterdam, Erasmus MC have proposed a pragmatic framework of strategies to reduce errors of diagnosis in hospitalized patients. While work in the outpatient setting estimates that 1 in 20 U.S. adults are misdiagnosed annually, researchers don't really know how common these errors are in U.S. hospitals. Some data is available from autopsies, but they are often not performed. In order to devise practical strategies to reduce errors in hospital medicine, the study used insights from error analysis to identify improvement opportunities within each of the five dimensions of diagnosis.

The five dimensions and selected examples from their list of suggestions are as follows:

  • Patient-physician encounter: allocate time to effectively communicate with patients; seek "cognitive support" to help decision-making in cases of uncertainty
  • Performance and interpretation of diagnostic tests: collaborate in person with lab professionals and radiologists to interpret complex test results or in cases of difficult diagnosis
  • Follow-up and tracking of diagnostic information over time: do not overlook past diagnostic data during the current hospitalization; clarify responsibilities of follow-up of abnormal test results
  • Subspecialty consultation-related communication and coordination: use direct verbal communication when making critical decisions; ensure everyone on the team is on same page about diagnosis when multiple consultants are involved
  • Patient-focused strategies: encourage proactive patient and family participation in the diagnostic process; encourage patients to look at their own medical notes to find inconsistencies

While this paper focuses on the hospital setting, many strategies are broadly applicable to other settings. The time is ripe to address measurement challenges of diagnostic errors, translate emerging scientific evidence to clinical practice, and work collaboratively with healthcare organizations, national policy makers and patient advocates to improve the safety of diagnosis.

Benny Agosto, Jr. is a partner at Abraham, Watkins, Nichols, Sorrels, Agosto & Friend in Houston, Texas. For over 65 years, Abraham Watkins has successfully represented injured people and families who fall victim to catastrophes. Our attorneys have the knowledge, experience and resources necessary to obtain just compensation their clients. For more information, please contact the office of Benny Agosto, Jr. at Abraham, Watkins, Nichols, Sorrels, Agosto & Friend, by letter at 800 Commerce Street, Houston, Texas 77002, or by phone at (713) 222-7211.

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