Learning From Patients' Experiences Related To Diagnostic Errors Is Essential For Progress In Patient Safety
Learning From Patients' Experiences Related To Diagnostic Errors Is Essential For Progress In Patient Safety
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DOI：
10.1377/hlthaff.2018.0698
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发表时间：
2018-11-01
期刊：
影响因子：
9.7
通讯作者：
Singh, Hardeep
中科院分区：
文献类型：
--
作者：
Giardina, Traber Davis;Haskell, Helen;Singh, Hardeep
诊断错误的研究主要集中在个人的临床医生的决策和系统设计，而忽略了从病人的信息。我们分析了一个独特的新的数据来源的患者和家庭报告的错误叙述，以探索因素，有助于诊断错误。从2010年1月至2016年2月期间提交的不良医疗事件报告中，我们确定了184例诊断错误的独特患者叙述。与患者-医生互动相关的问题成为主要贡献者。我们的分析确定了224例行为和人际因素，反映了不专业的临床医生行为，包括忽视患者的知识，不尊重患者，未能沟通，操纵或欺骗。患者的观点可以更全面地理解为什么会发生诊断错误，并有助于制定缓解策略。卫生系统应制定和实施正式的计划，收集患者在诊断过程中的经验，并利用这些数据促进组织文化，努力减少诊断错误造成的伤害。
Diagnostic error research has largely focused on individual clinicians' decision making and system design, while overlooking information from patients. We analyzed a unique new data source of patient- and family-reported error narratives to explore factors that contribute to diagnostic errors. From reports of adverse medical events submitted in the period January 2010-February 2016, we identified 184 unique patient narratives of diagnostic error. Problems related to patient-physician interactions emerged as major contributors. Our analysis identified 224 instances of behavioral and interpersonal factors that reflected unprofessional clinician behavior, including ignoring patients' knowledge, disrespecting patients, failing to communicate, and manipulation or deception. Patients' perspectives can lead to a more comprehensive understanding of why diagnostic errors occur and help develop strategies for mitigation. Health systems should develop and implement formal programs to collect patients' experiences with the diagnostic process and use these data to promote an organizational culture that strives to reduce harm from diagnostic error.