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Showing results for tags 'Diagnosis'.
Found 469 results
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Content ArticlePatients and families are important contributors to the diagnostic team, but their perspectives are not reflected in current diagnostic measures. Patients/families can identify some breakdowns in the diagnostic process beyond the clinician’s view. Bell et al. developed a framework with patients/families to help organisations identify and categorise patient-reported diagnostic process-related breakdowns (PRDBs) to inform organisational learning. The framework describes 7 patient-reported breakdown categories (with 40 subcategories), 19 patient-identified contributing factors and 11 potential patient-reported impacts. Patients identified breakdowns in each step of the diagnostic process, including missing or inaccurate main concerns and symptoms; missing/outdated test results; and communication breakdowns such as not feeling heard or misalignment between patient and provider about symptoms, events, or their significance. The PRDB framework can help organisations identify and reliably categorise PRDBs, including some that are invisible to clinicians; guide interventions to engage patients and families as diagnostic partners; and inform whole organisational learning.
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Content ArticleThere are many respects in which the modern medical system is not fit for purpose and poses a threat to human health. In so many situations, our superficial assumptions about medicine are wrong. Having more tests to identify disease is often not better than leaving those “well enough” alone, labelling people with a specific disease may not be helpful, and more medicine may not be better than less medicine or no medicine at all. In our eagerness to intervene, we can end up doing harm. This fits with the estimation that around 30% of medical care is ineffective and another 10% is harmful. But why do doctors recommend tests, or diagnose and prescribe treatments that don’t help people? Ian A Harris, an orthopaedic surgeon, and Rachelle Buchbinder, a professor of clinical epidemiology, discuss in this BMJ opinion article.
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Content ArticleThe need for radical investment and reform of diagnostic services was recognised at the time the NHS Long Term Plan was published in 2019. This report, commissioned by NHS England at that time, alongside a review of adult screening services, was nearing publication before the COVID-19 pandemic struck. However, while the recommendations made pre-pandemic still stand, additional actions will be needed to deliver safe, high quality diagnostic services in an endemic phase of the disease and to support the recovery of diagnostic services.
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Content ArticleThis study in the International Journal of Radiation Oncology, Biology and Physics assesses the impact of the early Covid-19 pandemic on incident learning through evaluation of events reported to the Radiation Oncology Incident Learning System® (RO-ILS) in the USA. The authors conclude that reporting to RO-ILS declined during the early Covid-19 pandemic, especially in hotspot areas, suggesting that resources and time were diverted away from incident reporting to address other critical needs. However, three of the five top reporting practices that stopped reporting during early Covid have since reported events after the analysis timeframe, suggesting the decline may be temporary.
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Content ArticleThis is the report of an inquiry conducted by the Health and Social Care Select Committee in 2020/21 which considers how the social care system is supporting those living with dementia. In the report the Committee make the case that the UK government’s plans for the health and care levy provides insufficient funding for social care over the next three years.
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Content ArticleThis article from the Agency for Healthcare Research and Quality (AHRQ) in the United States is the transcript of a conversation between AHRQ’s Acting Director David Meyers, MD, and the Agency’s chief patient safety official, Jeff Brady, MD MPH, about key issues in diagnostic safety. Diagnostic safety is “the newest frontier in patient safety,” according to Dr Brady, who emphasises the Agency’s commitment to improve diagnostic safety and explains how researchers are working to better understand diagnostic errors and design systems and processes to reduce errors.
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Content ArticleThis toolkit created by The National Academies of Sciences, Engineering and Medicine contains information and resources to help patients learn about and engage in the diagnostic process. There are many barriers to patients fully engaging in their diagnosis, and this toolkit aims to help patients take control of their role in the process, as well as equipping healthcare providers to create an atmosphere that allows patients to contribute meaningfully.
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Content Article
Improving diagnosis in health care (2015)
Patient-Safety-Learning posted an article in Diagnosis
This report from The National Academies of Sciences, Engineering and Medicine highlights three key themes around the issue of diagnostic error: The importance of diagnostic error in patient safety and the need to give the subject more research attention The central role that patients play in helping to avoid diagnostic error. The idea that diagnosis is a collaborative effort involving intra- and interprofessional teamwork. It also looks at several specific issues that must be addressed to reduce diagnostic errors. -
Content ArticleDiagnostic error occurs more frequently in the emergency department than in regular in-patient hospital care. This study in BMC Emergency Medicine sought to characterise the nature of reported diagnostic error in hospital emergency departments in England and Wales from 2013 to 2015. The authors identified the priority areas for intervention to reduce the occurrence of diagnostic error. The study found that system modifications are needed to support clinicians in assessing patients and interpreting investigations. Interventions to reduce diagnostic error need to be evaluated in the emergency department setting, and could include standardised checklists, structured reporting and technological investigation improvements.
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Content ArticleThis article by the Patient Safety Network provides an overview of the impact of diagnostic errors on patient safety. It gives examples of incorrect applications of heuristics and suggests ways to overcome cognitive bias in the diagnostic process.
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Content ArticleThis study in BMJ Quality & Safety examines how much electronic differential diagnostic support (EDS) systems improve diagnostic accuracy, and whether EDS should be used early or late in the diagnostic process. Using a volunteer sample of medical students and doctors at six Canadian medical schools, the authors compared the rate of correct diagnosis when EDS was used early and late in the diagnostic process. The study found that EDS increased the number of diagnostic hypotheses and the likelihood of correct diagnosis, and that these effects persisted whether EDS was used early or late in the diagnostic process.
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Content Article
Implementation Approaches for Closing the Loop (2019)
Patient-Safety-Learning posted an article in Diagnostic error
Delayed, missed and incorrect diagnoses are common causes of errors that result in patient harm and inappropriate care. However, some diagnostic errors may be avoided by effectively using health information technology. These resources from the Emergency Care Research Institute provide information on how to implement IT processes to close the loop on diagnostic evaluations. -
Content ArticleDiagnostic errors are the number one patient safety concern in healthcare today, inflicting harm on hundreds of thousands of patients in the USA annually. The problem is complex and involves the difficulties inherent in diagnosis generally, the known weaknesses of human cognition and the myriad breakdown points in our healthcare systems. In this BMJ Editorial, Mark Graber discusses the advantages of clinical decision support tools for diagnosis (CDS-Dx) and three promising trends regarding the uptake and potential use of CDS-Dx systems. Further reading: Co-development of OurDX - an online tool to facilitate patient and family engagement in the diagnostic process
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Content ArticlePatients and their families are usually the first to notice new or changing symptoms and they can play an important role in preventing diagnostic errors. This blog in BMJ Opinion describes how researchers, healthcare professionals and patients worked together to develop OurDX, an online tool designed to improve the efficiency of medical appointments and reduce diagnostic errors.
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Content ArticleThe Healthcare Safety Investigation Branch (HSIB) identified a patient safety risk caused by delays in diagnosing lung cancer. Lung cancer is the third most common cancer diagnosed in England, but accounts for the most deaths. Two-thirds of patients with lung cancer are diagnosed at an advanced stage of the disease when curative treatment is no longer possible, a fact which is reflected in some of the lowest five-year survival rates in Europe. Chest X-ray is the first test used to assess for lung cancer, but about 20% of lung cancers will be missed on X-rays. This results in delayed diagnosis that will potentially affect a patient’s prognosis. The HSIB investigation reviewed the experience of a patient who saw their GP multiple times and had three chest X-rays where the possible cancer was not identified. This resulted in an eight-month delay in diagnosis and potentially limited the patient’s treatment options.
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Content ArticleIn this article in the Anesthesia Patient Safety Foundation Newsletter, Katsuyuki Miyasaka talks about the history of the pulse oximeter in Japan and celebrates one of it's earliest developers, Takuo Aoyagi. The author recognises the life-saving impact of pulse oximeters, but talks about the need for more education and regulation around the use of this readily available device. Miyasaka highlights that the quality of devices is variable and that when patients attempt to interpret the numbers they see, it may lead to harm.
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Content ArticleClinical guidelines advise GPs in England which patients need urgent referral for suspected cancer. This study in BMJ Quality & Safety used linked primary care, secondary care and cancer registration data to assess: how often GPs follow the guidelines on cancer referral whether certain patients are less likely to be referred how many patients were diagnosed with cancer within one year of non-referral. The study included patients who presented for the first time with blood in the urine, breast lump, difficulty swallowing, iron-deficiency anaemia and post-menopausal or rectal bleeding during 2014–2015. The authors found that the majority of patients presenting with common possible cancer symptoms were not being referred by GPs in line with clinical guidelines. They also found that a significant number of these patients went on to develop cancer within a year, and suggest that improvement is needed in the cancer diagnosis process.
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Content ArticleThis article in Patient Safety looks at a new approach to identifying and monitoring patients with sepsis developed by a team of nurses at WellSpan Health in the USA. The Central Alert Team (CAT) works remotely, looking for indicators of sepsis in patient charts and vital signs. They relay information and treatment advice to nurses working at the bedside and take an adaptive approach to find the best ways of working. This focused approach means the CAT nurses are able to quickly identify patients who are deteriorating and ensure treatment is administered at the right time.
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Content ArticleThis report by The Hearts, Minds and Genes Coalition for Eating Disorders aims to highlight the cost of eating disorders in the UK. It examines: the financial cost of eating disorders to the NHS the financial, social and emotional impact on individuals, families and wider society the ongoing loss of lives to treatable illnesses. It estimates the costs of eating disorders, highlights current gaps in data and gives recommendations for change.
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Content Article
Delay in recognising placental abruption (30 June 2021)
Patient-Safety-Learning posted an article in Maternity
This case story about placental abruption, published by NHS Resolution, highlights the importance of regular risk assessments throughout labour to help prevent harm to mother and baby. It provides learning points and considerations that can be applied across all maternity units. -
Content ArticleThe Alzheimer’s Society has published three reports on dementia diagnosis to identify and address the challenges faced by people accessing a dementia diagnosis.
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Content ArticleFind out how patient safety depends on pathologists and laboratories in a new interactive infographic from the Royal College of Pathologists.
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Content ArticleDiagnostic errors have a negative impact on patient treatment and cost healthcare systems a large amount in wasted resources. This paper published by the Deeble Institute for Health Policy Research looks at diagnostic errors related to medical imaging in Australian public healthcare. It also looks at health policies that have been used internationally to improve the use of diagnostic imaging and reduce the consequences of diagnostic errors. The authors recommend: implementing a national strategy in Australia to identify and prevent diagnostic errors analysing medical indemnity claims to help measure the incidence and consequences of diagnostic errors.
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Content Article
Think Aorta
PatientSafetyLearning Team posted an article in Improving patient safety
Think Aorta is a global campaign focused on the problem of misdiagnosis and delay in acute aortic dissection. It was created and is led by Aortic Dissection Awareness UK & Ireland. Think Aorta provides free, accredited learning resources for emergency medicine and radiology teams and for first responders, improving their ability to spot a time-critical, life-threatening aortic dissection and take appropriate action. -
Content Article
The Aortic Dissection Charitable Trust
PatientSafetyLearning Team posted an article in Improving patient safety
The Aortic Dissection Charitable Trust aims to improve the diagnosis of aortic dissection and bring consistency of treatment across the whole patient pathway. They accomplish this through: Increased access to education for medical professionals and patients in the UK & Ireland Working with those responsible for Healthcare policy in the UK & Ireland to ensure that there is consistency in the provision of diagnosis for acute aortic dissection, specialised follow-up for survivors and access to clinical genetics for relatives Promoting funding for medical research into the detection, prevention, treatment and cure of aortic dissection. Follow the link below to access their resources.
