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What Is a Diagnosis?

Achieving an accurate and timely diagnosis is essential to safe and effective health care.

Diagnosis is the process where patients and their care teams work together to identify the nature and cause of a patient's health problem. This may include discussing the patient's symptoms and medical history, conducting a physical exam, and performing diagnostic tests, such as a blood test or ultrasound. Diagnosis involves a cycle of gathering, combining, and understanding information (1).

Diagnosis is: 

Complex

Diagnosis involves uncertainty and may change overtime as new information becomes available or the patient's condition evolves.

Patient-Centered

The diagnostic process aligns with the individual needs, values, and preferences of a patient.

Collaborative

Diagnosis requires ongoing coordination and communication  among a diverse team of healthcare professionals, the patient, and their family.

Important

Diagnosis forms the basis of a treatment plan. It helps healthcare professionals determine the most appropriate course of action.

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What Is Diagnostic Error?

The National Academics of Science, Engineering, and Medicine (NASEM) defines diagnostic error as "the failure to a) establish an accurate and timely explanation of the patient's health problem(s) or b) communicate the explanation to the patient" (1).
Diagnostic errors can result in significant implications for the patient, as they can lead to delayed, inappropriate, or unnecessary treatment. Consequently, these errors may lead to devasting health effects, heighten psychological distress, and impose financial repercussions.

$

38

+

billion (USD) was the sum of diagnosis related payments from 1986 to 2010 (2). 

So What?

Diagnostic errors are one of the most important global medical safety issues. Almost everyone will experience one diagnostic error in their lifetime (1). They introduce potentially serious risks for patients, families, and the healthcare system. 

47

%

+

of diagnostic error-related adverse events result in serious disability (3).

78

%

+

of diagnostic errors are related to the patient-practitioner encounter (4).

Diagnostic Safety Resources:

By improving diagnostic safety initiatives, healthcare organizations can minimize the potential for diagnostic errors, improve patient outcomes, and enhance the overall quality of care. Below are existing resources designed to foster active patient engagement and decrease the prevalence of miscommunication in diagnosis:

Society to Improve Diagnosis in Medicine Patient Toolkit

Encourages active participating and partnership with healthcare professionals by providing prompts and questions to guide patients in communicating their concerns, medications, and symptoms clearly. 

1

Be the Expert on You Tool

Prevents miscommunication errors by allowing patients to share their stories concisely by using a structured fillable form.

2

60 Seconds to Improve Diagnostic Safety

Patients are often interrupted by their care providers within the first 11-18 seconds of sharing their diagnostic story. This tool trains healthcare professionals to engage in reflective listening for one minute before asking questions.

3

References

  1. National Academies of Sciences, Engineering, and Medicine. 2015. Improving Diagnosis in Health Care. Washington, DC: The National Academies Press. https://doi.org/10.17226/21794. 

  2. Saber Tehrani AS, Lee H, Mathews SC, Shore A, Makary MA, Pronovost PJ, et al. 25-year summary of US malpractice claims for diagnostic errors 1986–2010: An analysis from the National Practitioner Data Bank. BMJ Quality & Safety. 2013;22(8):672–80. doi:10.1136/bmjqs-2012-001550

  3. Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, et al. The nature of adverse events in hospitalized patients. New England Journal of Medicine. 1991;324(6):377–84. doi:10.1056/nejm199102073240605

  4. Singh H, Giardina TD, Meyer AN, Forjuoh SN, Reis MD, Thomas EJ. Types and origins of diagnostic errors in primary care settings. JAMA Internal Medicine. 2013;173(6):418. doi:10.1001/jamainternmed.2013.2777   

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