<i>Annals</i> for Hospitalists Inpatient Notes - Reducing Diagnostic Error—A New Horizon of Opportunities for Hospital Medicine
Authors: Hardeep Singh, Laura Zwaan
Journal: Annals of Internal Medicine (2016)

Web Exclusives18 October 2016Annals for Hospitalists Inpatient Notes - Reducing Diagnostic Error—A New Horizon of Opportunities for Hospital MedicineHardeep Singh, MD, MPH and Laura Zwaan, PhDHardeep Singh, MD, MPHFrom Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, and Institute of Medical Education Research Rotterdam, Erasmus MC, Rotterdam, the Netherlands. and Laura Zwaan, PhDFrom Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, and Institute of Medical Education Research Rotterdam, Erasmus MC, Rotterdam, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-2042 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The recent Institute of Medicine report, "Improving Diagnosis in Health Care," has highlighted diagnostic errors as a major source of preventable harm (1, 2). Given the importance of diagnoses in the hospital, hospitalists are well-positioned to lead efforts to promote correct and timely diagnosis. However, to reduce harms from diagnostic errors, hospitalists must first understand how these errors occur and then develop practical strategies to avoid them.Defining whether a diagnostic error has occurred can be difficult. Diagnosis evolves over time, often across multiple providers and settings. Standards for diagnostic accuracy and timeliness for most conditions are ill-defined, and physicians ...References1. Institute of Medicine. Improving Diagnosis in Health Care. Washington, DC: National Academies Pr; 2015. Google Scholar2. Singh H, Graber ML. Improving diagnosis in health care—the next imperative for patient safety. N Engl J Med. 2015;373:2493-5. [PMID: 26559457] doi:10.1056/NEJMp1512241 CrossrefMedlineGoogle Scholar3. Zwaan L, Singh H. The challenges in defining and measuring diagnostic error. Diagnosis (Berl). 2015;2:97-103. [PMID: 26955512] CrossrefMedlineGoogle Scholar4. Singh H, Sittig DF. Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework. BMJ Qual Saf. 2015;24:103-10. [PMID: 25589094] doi:10.1136/bmjqs-2014-003675 CrossrefMedlineGoogle Scholar5. Zwaan L, de Bruijne M, Wagner C, Thijs A, Smits M, van der Wal G, et al. Patient record review of the incidence, consequences, and causes of diagnostic adverse events. Arch Intern Med. 2010;170:1015-21. [PMID: 20585065] doi:10.1001/archinternmed.2010.146 CrossrefMedlineGoogle Scholar6. Zwaan L, Monteiro S, Sherbino J, Ilgen J, Howey B, Norman G. Is bias in the eye of the beholder? A vignette study to assess recognition of cognitive biases in clinical case workups. BMJ Qual Saf. 2016. [PMID: 26825476] doi:10.1136/bmjqs-2015-005014 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, and Institute of Medical Education Research Rotterdam, Erasmus MC, Rotterdam, the Netherlands.Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or other funding agencies.Acknowledgment: The authors thank Andrea Bradford, PhD, for assistance with medical editing.Grant Support: Dr. Singh is supported by the VA Health Services Research and Development Service (CRE 12-033; Presidential Early Career Award for Scientists and Engineers USA 14-274), the VA National Center for Patient Safety, the Agency for Healthcare Research and Quality (R01HS022087 and R21HS023602), and the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413). Dr. Zwaan is supported by the Netherlands Organization for Scientific Research (NWO-VENI grant).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2042.Corresponding Author: Hardeep Singh, MD, MPH, Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard (152), Houston, TX 77030; e-mail, [email protected]edu.Current Author Addresses: Dr. Singh: Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard (152), Houston, TX 77030.Dr. Zwaan: Institute of Medical Education Research Rotterdam, Erasmus MC, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 18 October 2016 David H. Wesorick and Vineet Chopra Annals On Call - Reducing Diagnostic Error Robert M. 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