‘To Err is Human’ series: A further report from the Institute of Medicine USA

Released today is a report entitled ‘Improving Diagnosis in Health Care‘, a continuation of the landmark Institute of Medicine reports To Err is Human: Building a Safer Health System (2000) and Crossing the Quality Chasm: A New Health System for the 21st Century (2001).

The new report concludes that diagnosis and, in particular, the occurrence of diagnostic errors has been largely unappreciated in efforts to improve the quality and safety of health care.

A series of recommendations is made in the report, based on eight goals:

  1. Facilitate more effective teamwork in the diagnostic process among health care professionals, patients, and their families;
  2. Enhance health care professional education and training in the diagnostic process;
  3. Ensure that health information technologies support patients and health care professionals in the diagnostic process;
  4. Develop and deploy approaches to identify, learn from, and reduce diagnostic errors and near misses in clinical practice;
  5. Establish a work system and culture that supports the diagnostic process and improvements in diagnostic performance;
  6. Develop a reporting environment and medical liability system that facilitates improved diagnosis by learning from diagnostic errors and near misses;
  7. Design a payment and care delivery environment that supports the diagnostic process;
  8. Provide dedicated funding for research on the diagnostic process and diagnostic errors.

The report summary concludes:

Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers.

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