Introduction

The Society to Improve Diagnosis in Medicine (SIDM) is conducting a survey to identify effective tools or interventions intended to improve diagnostic performance or reduce harm associated with diagnostic error. This information will be used by SIDM to develop a Diagnostic Error Change Package, that will be made available to HRET by August 2018. We ask that you please submit your survey responses by June 8th, 2018.

What is Diagnostic Error?
The National Academy of Medicine (formerly the Institute of Medicine [IOM]) defined 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.

These categories overlap, but examples help illustrate some differences:

A delayed diagnosis refers to a case where the diagnosis should have been made earlier. Delayed diagnosis of cancer is by far the leading entity in this category. A major problem in this regard is that there are very few good guidelines on making a timely diagnosis, and many illnesses aren’t suspected until symptoms persist, or worsen.

A wrong diagnosis occurs, for example, if a patient truly having a heart attack is told their pain is from acid indigestion. The original diagnosis is found to be incorrect because the true cause is discovered later.

A missed diagnosis refers to a patient whose medical complaints are never explained. Many patients with chronic fatigue, or chronic pain fall into this category, as well as patients with more specific complaints that are never accurately diagnosed.

For our purposes here, we define tool as an intervention that helps users accomplish a specific diagnostic task. The following list provides some examples that illustrate relevant tools or interventions:

Examples:
·       Measures and a process to collect data
·       Trigger tools
·       Checklist
·       Simulation software
·       Patient or healthcare professional educational programs and materials
·       Practice/strategy such as a diagnostic time-out
·       Grand rounds focused on diagnostic error
·       Root cause analysis focused on diagnostic error
·       Guidelines (both clinical and non-clinical)
·       Framework
·       Algorithm
·       Flow map
·       Policies

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