Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 21;9(6):e773.
doi: 10.1097/pq9.0000000000000773. eCollection 2024 Nov-Dec.

Diagnostic Safety: Needs Assessment and Informed Curriculum at an Academic Children's Hospital

Morgan Congdon  1   2   3 , Irit R Rasooly  1   2   3   4 , Regina L Toto  1   2 , Danielle Capriola  5 , Anna Costello  1   6 , Richard J Scarfone  1   2 , Anna K Weiss  1   2
Affiliations

Diagnostic Safety: Needs Assessment and Informed Curriculum at an Academic Children's Hospital

Morgan Congdon et al. Pediatr Qual Saf. .

Abstract

Background: Diagnostic excellence is central to healthcare quality and safety. Prior literature identified a lack of psychological safety and time as barriers to diagnostic reasoning education. We performed a needs assessment to inform the development of diagnostic safety education.

Methods: To evaluate existing educational programming and identify opportunities for content delivery, surveys were emailed to 155 interprofessional educational leaders and 627 clinicians at our hospital. Educational leaders and learners were invited to participate in focus groups to further explore beliefs, perceptions, and recommendations about diagnostic reasoning. The study team analyzed data using directed content analysis to identify themes.

Results: Of the 57 education leaders who responded to our survey, only 2 (5%) reported having formal training on diagnostic reasoning in their respective departments. The learner survey had a response rate of 47% (293/627). Learners expressed discomfort discussing diagnostic uncertainty and preferred case-based discussions and bedside learning as avenues for learning about the topic. Focus groups, including 7 educators and 16 learners, identified the following as necessary precursors to effective teaching about diagnostic safety: (1) faculty development, (2) institutional culture change, and (3) improved reporting of missed diagnoses. Participants preferred mandatory sessions integrated into existing educational programs.

Conclusions: Our needs assessment identified a broad interest in education regarding medical diagnosis and potential barriers to implementation. Respondents highlighted the need to develop communication skills regarding diagnostic errors and uncertainty across professions and care areas. Study findings informed a pilot diagnostic reasoning curriculum for faculty and trainees.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Pareto chart of potential barriers to implementation of the curriculum.
See this image and copyright information in PMC

References

    1. Saber Tehrani AS, Lee H, Mathews SC, et al. . 25-Year summary of US malpractice claims for diagnostic errors 1986-2010: an analysis from the National Practitioner Data Bank. BMJ Qual Saf. 2013;22:672–680. - PubMed
    1. Committee on Diagnostic Error in Health Care, Board on Health Care Services, Institute of Medicine, The National Academies of Sciences, Engineering, and Medicine. Improving Diagnosis in Health Care. In: Balogh EP, Miller BT, Ball JR, eds. National Academies Press; 2015. - PubMed
    1. Yang D, Fineberg HV, Cosby K. Diagnostic excellence. JAMA. 2021;326:1905–1906. - PubMed
    1. Agency for Healthcare Research and Quality. Measure Dx: a resource to identify, analyze, and learn from diagnostic safety events. 2022. Available at https://www.ahrq.gov/patient-safety/settings/multiple/measure-dx.html. Accessed September 30, 2022.
    1. Singh H, Graber ML. Improving diagnosis in health care--the next imperative for patient safety. N Engl J Med. 2015;373:2493–2495. - PubMed

LinkOut - more resources