Impact of Diagnostic Errors in Healthcare

Introduction

Diagnostic errors remain be to one of the largest contributors to healthcare errors in not only the past, but also the present. Diagnostic errors are defined as, “an error or delay in diagnosis; failure to employ indicated tests; use of outmoded tests or therapy; failure to an act of results of monitoring or testing” (Ball, Balogh, Miller, 2015). In 2015, the Institute of Medicine disclosed substantial information emphasizing diagnostic error as a blind spot in any healthcare organization safety management scheme (Rice, 2015). However diagnostic error received less scrutiny from the public eye despite its continuous occurrence. Thus, diagnostic error is approximately estimated about 17 percent of preventable error in the healthcare industry. It is very critical for healthcare organizations and administrators to immediately address diagnostic errors due to its paramount effect and challenge to patient quality and safety. Although such a move necessitates notable effort, it will aid the organizations in establishing safety precautions pertaining to diagnostic error (Graber, Trowbridge, Myers, Umscheid, Strull, & Kanter, 2014). The purpose of this essay is to discuss the diagnostic errors in the healthcare setting, strategies to reduce diagnostic errors, and how nurses can reduce diagnostic errors.

Diagnostic Errors

Diagnostic errors have become recognized as a major concern for patient safety. A recent study from the American Medical Association (AMA) Center for Patient Safety drafted a report that focused on, “the important of diagnostic error and the critical need for future research on this topic (McGinley, & Singh, 2013). The study found that one of the major recurring themes in diagnostic errors is communication. Effective and efficient communication beginning with the initial patient-provider encounter, diagnosis, testing, referrals, procedures, and follow-up is vital to reduce the number of diagnostic errors (McGinley, & Singh, 2013). There are several barriers within the healthcare field that contribute to diagnostic errors. For example, time and workload pressure, volume of electronic and verbal communication, and patient transfers with lack of communication through the process are just a few. To better address the issue of diagnostic error, we need to identify at what point the communication breakdown occurs in the process. Recognizing that communication in a healthcare setting is used as a two-way communication mechanism to elicit a response but also transmit information (Singh, 2013).

Threats to Patient Safety

Diagnostic results specify a detailed and accurate explanation of patient’s general health information enabling physicians to make the right judgment in terms of healthcare decisions. With the wrong diagnostic results then the patient’s plan of care can be affected. Diagnostic errors are also considered harmful to the patient besides the various safety concerns in the healthcare system (medication error, hospital acquired infections, and mislabeling). Medical error can be a threat to patient safety because physicians prescribes patients different medications based on the diagnostic results. Patients are prone to get injured physically in their body due to taking the wrong medication or wrong operation based on an error in their diagnostic results. Sometimes death can occur.

Strategies to Reduce Diagnostic Errors

Strategies that can take place to reduce diagnostic errors are proper training in communication, ensuring there is a process in place for diagnosis, or even putting a new method in place to address the shortcoming in the process. Diagnostic errors are not well understood but are a frequent cause of medical errors. It is important that we trace back to find the root cause of the errors and focus on reigning our processes in through more efficient and effective communication. There are six ways to reduce diagnostic errors in the healthcare setting. Facilitate better teamwork in the diagnostic process between clinical staff, patients and their families, enhance education and training on making the correct diagnosis, Ensure health IT supports patients and healthcare professionals in the diagnostic process (White, 2015). Implement a system that identifies diagnostic errors, and includes steps to correct and prevent them, create a work system and culture designed to support the diagnostic process and encourage improvement, and lastly, develop a reporting environment that’s conducive to improving diagnoses through learning from errors (White, 2015).

Investigation in Workplace

In my place of employment diagnostic errors has not been a patient safety concern. The reason why is that in my place of employment, the nurses do bedside report. By doing bedside report the oncoming nurse is aware what is going on with patient’s care of plan, such as different diagnostic procedures that would take place that day or in the future. Also, the diagnostic technicians communicate with nurses if they feel that the physician order the wrong diagnostic procedure. This will help the nurses to get in contact with the physician before the patient go have the diagnostic procedure done. In my place of employment, we do read back between the diagnostic technicians and the nurse whenever there is a critical value. The nurses have thirty minutes to call the physician, for he/she can be aware.

Nurses Implementation

“Nurses play a key role in the diagnostic process in that they ensure communication and care coordination among diagnostic team members, monitor patients and may identify potential diagnostic inconsistencies or errors” (Becker’s Healthcare, 2015). Physicians are often incognizant of the diagnostic errors occurred. For that reason, it is very critical for nurses to have a continuous feedback regarding their diagnostic completion. The different ways that nurses can help reduce diagnostic errors are knowing the major diagnosis of their patient, advocate on the patient’s behalf while navigating their healthcare, assist the diagnostic team by detecting, reporting and documenting any and all changes in the patient’s symptoms, signs, complaints or conditions, monitor the diagnostic team as well as the patient to make sure he or she is responding to treatment as expected, optimize communication between the patient and the care team by helping the patient tell their story and connect all of their symptoms while also making sure the patient understands his or her diagnosis (Becker’s Healthcare, 2015). Be a watchdog for appropriate care coordination, teach patients about the diagnostic process, learn about how diagnostic errors occur and how they can be prevented, educate patients about diagnostic tests, why they are necessary and what the results will reveal, as well as explain what the patient should expect, and lastly, support patients during emotionally and psychologically difficulties times, such as when a diagnosis is not yet known or is known to be bad (Becker’s Healthcare, 2015).

Conclusion

This essay discussed diagnostic errors in the healthcare setting, different strategies on how to reduce diagnostic errors, and different ways nurses can reduce diagnostic errors. Healthcare organizations and administrators should have a collaborative goal on breaking down diagnostic errors. It is very critical for healthcare organizations to be aware of different diagnostic errors because it can affect the patient’s safety.

References

• Ball, J., Balogh, E., & Miller, B. T. (2015). Improving diagnosis in health care. Washington, DC: The National Academies Press.
• Becker’s Healthcare. (2015). 10 ways nurses can improve diagnoses, reduce errors. Retrieved from https://www.beckershospitalreview.com/quality/10-ways-nurses-can-improve-diagnoses-reduce-errors.html
• Graber, M. L., Trowbridge, R., Myers, J. S., Umscheid, C. A., Strull, W., & Kanter, M. H. (2014). The Next Organizational Challenge: Finding and Addressing Diagnostic Error. The Joint Commission Journal on Quality and Patient Safety, 40(3), 102-110. doi:10.1016/s1553-7250(14)40013-8
• McGinley, P., & Singh, H. (2013). Diagnostic Error: Safe and Effective Communication to Prevent Diagnostic Errors. Retrieved from https://www.psqh.com/analysis/safe-and-effective-communication-to-prevent-diagnostic-errors/
• Rice, S. (2015). Diagnostic errors a persistent ‘blind spot’. Retrieved from http://www.modernhealthcare.com/article/20150922/NEWS/150929987
• Singh, H. (2013). Types and Origins of Diagnostic Errors in Primary Care Settings. Retrieved from http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1656540
• White, J. (2015). 6 ways to reduce diagnostic errors in hospitals. Retrieved from http://www.healthcarebusinesstech.com/reduce-diagnostic-errors/