This member-only article appears in the January issue of Patient Safety Monitor Journal.
By Christopher Cheney, HealthLeaders
Drawing information from patients can help boost understanding of why diagnostic errors happen and reduce the risk of future errors, according to new research. Diagnostic errors are a serious patient safety problem, impacting about 12 million adult outpatients each year and causing as many as 17% of adverse events for hospitalized patients.
“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,” researchers wrote in an article published today in the journal Health Affairs.
The research features an examination of 184 narratives from patients or family members about diagnostic errors collected in a new database maintained by the Empowered Patient Coalition.
The data provide unique and valuable insight into diagnostic errors, the researchers wrote.
“Patients’ reports of their experiences of diagnostic errors can provide information that traditional measurement mechanisms often fail to capture. Given the absence of diagnosis-specific experiences in most surveys and patient-reported outcomes, the only current way to capture patients’ experiences of diagnostic error is via patient complaints. However, complaints are often viewed as satisfaction matters rather than safety signals,” the researchers wrote.
The Empowered Patient Coalition narratives identified four areas where poor clinician-patient relations contributed to diagnostic errors:
- Patient knowledge was ignored in 92 of the narratives. Patients or family members said that clinicians ignored or disregarded reports of clinical indications such as symptoms and changes in patient status.
- Disrespect of patients was considered a possible contributing factor in several diagnostic errors. Clinician disrespect of patients was reported in several forms, such as belittling, mocking, and stereotyping.
- Failure to communicate was another theme in the narratives, with clinician failings ranging from ineffective communication styles to refusal to talk with patients and family members. Examples of poor communication included unanswered phone calls and unresponsiveness to questions.
- Manipulation or deception was reported in 15 of the narratives. This behavior fell into two categories: clinicians using fear to influence care decisions, and patients being misled or misinformed.