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Highlighting the difficulty in tracking diagnostic error rates

Working professionals in Providence County likely face some form of evaluation system in their jobs, particularly in how they identify errors in their workflow. Most may assume that if their work is being scrutinized, so too is that of other professionals. For doctors, identifying errors is most applicable to diagnosing patients. Thus, many may think that doctors are evaluated based upon their diagnostic accuracy. Yet as shocking as it may seem, according to the Agency for Healthcare Research and Quality, a lack of standardized measurement strategies makes it difficult for researchers to include diagnostic accuracy among the quality measurements used to evaluate doctor performance.

The National Academy of Medicine estimates that nearly everyone will experience a diagnostic error at some point. At the same, however, it recognizes that tracking the rate at which such errors occur is currently not a major focus of research. One of the major barriers it lists to forming a standardized method of measuring the occurrence rate of diagnostic errors is the current methods by which they are reported. These include:

  •          Medical records
  •          Postmortem exams
  •          Diagnostic testing (including medical imaging)
  •          Surveys of patients and clinicians
  •          Medical malpractice and health insurance claims

It is recognized that each of these sources approaches the issue of diagnostic accuracy from different perspectives of the problem. However, in a 2015 report reviewing diagnostic errors, NAM does conclude that urgent attention is needed to better understand and monitor the impact of this problem.

In that same report, NAM also defined diagnostic errors as “the failure to establish an accurate and timely explanation of the patient’s health problem(s), or communicate that explanation to the patient.” This definition highlights the reciprocal nature of the doctor-patient relationship, implying that increased patient engagement could also play a role in limiting diagnostic errors. 

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