5 Tips for Avoiding Diagnostic Errors

Cheryl Clark, for HealthLeaders Media , September 8, 2010

Second, the game-changing report published by the Institute of Medicine nearly 11 years ago, To Err Is Human, estimated that medical errors cause between 44,000 and 98,000 deaths annually, which it drew from another report, the Harvard Medical Practice Study.

But what the IOM failed to mention was that the Harvard study it drew from also noted that of all medical adverse events, 17% were due to diagnostic errors, "far more than medication errors," which are the focus of so much preventive spending and effort today, Wachter says. "If you review the IOM report, the term 'medication errors' is mentioned 70 times, while 'diagnostic errors' occurs twice," he wrote.

Third, diagnostic errors account for twice as many malpractice lawsuits as other types of medical errors.

What all this means is that doctors are missing an enormous opportunity to save lives, prolong or improve lives, avoid waste in the healthcare system and save money.

Somewhere the patient safety movement has drawn a trajectory for improvement, but it has left the challenges of improving patient diagnoses far behind, he says. Neither the National Quality Forum's list of 'never events' and the Agency for Healthcare Research and Quality's Patient Safety Indicators includes a diagnostic error.

Wow, I thought. This is huge!

Of course there are many understandable reasons why the patient safety movement now focuses on these other preventable medical mishaps, such as wrong-site surgery, forgotten foreign surgical objects, medication errors, hospital acquired infections, and a variety of other hospital-associated mishaps resulting in shocks, burns, or falls.

Wachter provided a few.

In improving patient safety, he says, "thoughtful people look for low-hanging fruit, things that are easy to measure, and then that becomes the scope of a problem," he told me this week. "These are not trivial errors. But the conspiracy that occurs is the conspiracy of measurement. It's so much easier to measure whether you gave the patient the right medication than it is to measure whether you made the right diagnosis.

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