ACP HospitalistReplace Diagnostic Errors with Excellence

Reframing Diagnostic Errors towards Diagnostic Excellence: The Five-step Strategy

As diagnostic errors continue to pose a significant challenge in the healthcare sector, Dr. Hardeep Singh from the Baylor College of Medicine offers an innovative approach to not just reduce these errors, but to redefine and promote diagnostic excellence. By following a five-step strategy, both physicians and health organizations can enhance diagnostic procedures, ensuring higher accuracy, efficiency, and patient satisfaction.

Here are the key highlights from Dr. Singh’s session at the Internal Medicine Meeting 2023:

• Diagnostic error is a widespread problem, shown in an analysis of spinal epidural abscess cases where 55.5% involved diagnostic errors.
• Diagnostic excellence is defined as accurate, timely diagnoses using minimal resources, providing an optimal patient experience and managing inherent uncertainties.
• A five-step strategy for physicians to achieve diagnostic excellence includes:
  • Seeking diagnostic feedback: Use tools like Calibrate Dx to review and learn from past cases, inviting feedback from colleagues or patients.
  • “Byte-sized” learning activities: Engage in daily, brief digital learning activities to improve diagnostic reasoning.
  • Considering biases: Recognize potential bias in patient treatment and strive to build empathy and find common ground with patients.
  • Making diagnosis a team sport: Collaborate with multidisciplinary teams, including patients and AI, in the diagnostic process.
  • Fostering critical thinking: Encourage skepticism towards one’s own decisions and revisit diagnoses if patients aren’t improving.
• Dr. Singh advocates for health care organizations to become Learning and Exploration of Diagnostic Excellence (LEDE) organizations, integrating diagnostic excellence into their culture.
• LEDE organizations should establish a coordinating hub, generate and apply new evidence, engage clinicians in diagnostic improvement, foster a culture of accountability and patient engagement, and measure for improvement and learning.