Developing a Framework to Study and Improve Communication to Enhance Diagnostic Quality in the ED

项目总结/文摘:

PROJECT SUMMARY/ABSTRACT: Medical diagnosis is one of the most difficult cognitive tasks for the human mind, and the inherent uncertainty of the diagnostic process makes it highly susceptible to errors. Clinicians working in emergency departments (EDs) are particularly vulnerable to making diagnostic errors because decision-making occurs in a time- and information-constrained context. There are ~141 million annual ED visits in the US. A conservative estimate of diagnostic error present in 5% of ED visits translates to ~7 million cases of ED-based diagnostic errors per year, with nearly half having the potential for patient harm. There is a critical need to understand the impact of communication-related errors occurring over an ED encounter. Communication breakdowns can occur at multiple levels and at varied points during the patient’s diagnostic journey in the ED. Patients may not be able to accurately communicate their symptoms or history to clinicians for a variety for reasons (e.g., low health literacy, language barriers, stress). The quality and quantity of communication between providers has a direct impact on the diagnostic process as well. Yet, our recent systematic review revealed no existing framework or intervention for investigating communication failures in the ED context, thus inhibiting testing in a methodical manner. The purpose of this conference is to develop an ED-specific framework to study communication in the diagnostic decision-making process through consensus methods with a robust team of relevant stakeholders (i.e., physicians, nurses, patients, caregivers, administrators). Our long-term goal is to reduce diagnostic errors in the ED by improving communication among patients, clinicians, and other members of the diagnostic team. Our sole specific aim for this consensus panel is to refine existing communication frameworks and create an ED-specific communication framework to enhance diagnostic safety.