A diagnosis that was unintentionally delayed, was wrong or was not performed ” following the definition published in September 2015 by the Institute of Medicine (IOM), now called the Health and Medicine Division (HMD), a unit of the National Academies of Science of United States, in the document “Improving the Diagnosis in Health Care”.
In this document, DE is defined as the failure to establish a safe and timely explanation of the patient’s health problem or a failure in the communication to the patient. This definition is framed from the perspective of the patient, who is the direct target of damage by diagnosis error. It also reflects the iterative and complex nature of the diagnostic process and the consideration that is somewhat more complex than the simple labeling of a disease or coding. According to the same report, improving the diagnostic process is not only possible, but represents a moral, professional and public health imperative.Considering the tools for detection and searching a DE, perhaps applying the trigger’s tool could be the most appropriate. That is, the automated analysis of certain circumstances that can detect a DE. There are publications where the search for emergency or office visits within 14 days prior to an urgent hospitalization, may serve to find DE that could have prevented hospitalization.Obviously, checklist systems for particular symptoms in emergencies may be also a tool to avoid DE, but commercial assistance systems such as Isabelhealthcare, have not demonstrate in practice an improvement in diagnostic accuracy to date.
Author: Dr. Eduardo Schnitzler. Pediatric and Intensive Care Unit. Management and Health Economics specialist. ITAES. SACAS. ARGENTINA