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Diagnostic Errors in Healthcare

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Diagnostic Errors in Healthcare

Diagnostic errors pose a significant safety quality issue in healthcare settings, affecting

patient outcomes, trust in healthcare, economic implications, and the well-being of healthcare

professionals. This paper will analyze the elements of this safety challenge, explore evidence-

based solutions, and discuss the role of nurses and other stakeholders in addressing and

preventing diagnostic errors.

Factors Leading to Diagnostic Errors

Diagnostic errors often stem from cognitive biases and heuristics that influence decision-

making among healthcare professionals. These mental shortcuts can lead to rapid but flawed

judgments, especially in situations with high uncertainty. For example, confirmation bias, where

clinicians favor information confirming their initial diagnosis, may result in overlooking

alternative possibilities, contributing to diagnostic errors (Croskerry, 2022).

Ineffective communication and information transfer among healthcare team members can

be a significant factor in diagnostic errors. Miscommunication about patient history, symptoms,

or test results can lead to misunderstandings and incorrect conclusions. For instance, if critical

details are not adequately conveyed during handovers between shifts or among different

specialties, it increases the likelihood of diagnostic inaccuracies (Hussain et al., 2019).

Systemic factors within healthcare settings, such as time constraints and workload

pressures, contribute to diagnostic errors. Healthcare professionals may face time limitations

during patient encounters, leading to rushed assessments and decisions. High patient volumes

and heavy workloads can hinder thorough examination and thoughtful consideration of

differential diagnoses, elevating the risk of errors in diagnostic reasoning (Barwise et al., 2021).
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Incomplete or inaccessible patient information can impede accurate diagnoses.

Fragmented health records, uncoordinated care across different providers, and gaps in

information sharing between primary care and specialty services can hinder healthcare

professionals' ability to form a comprehensive understanding of the patient's medical history.

Without a holistic view, clinicians may miss crucial details essential for accurate diagnoses

(Merker et al., 2022).

Evidence-Based and Best-Practice Solutions to Improve Patient Safety and Reduce

Costs in Diagnostic Errors

Implementing Clinical Decision Support Systems (CDSS) represents a critical evidence-

based solution to enhance diagnostic accuracy and mitigate errors. CDSS integrates patient data

with evidence-based medical knowledge, offering real-time guidance to healthcare professionals

during the diagnostic process. This technology assists in identifying potential diagnoses,

ensuring comprehensive consideration of relevant information, and reducing cognitive biases. By

supporting clinicians in making well-informed decisions, CDSS contributes to improved patient

safety and can potentially reduce unnecessary tests and treatments, thereby curtailing associated

costs (Sutton & Pincock, 2020).

Promoting interdisciplinary collaboration and adopting a team-based approach to patient

care is a best-practice solution for addressing diagnostic errors. Engaging healthcare

professionals from various specialties encourages diverse perspectives, reducing the likelihood

of individual cognitive biases. Regular team discussions and case reviews foster a collective

decision-making process, enhancing diagnostic accuracy. This collaborative model not only

contributes to improved patient safety by minimizing errors but also streamlines communication,
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potentially reducing the costs associated with redundant or unnecessary procedures (Zenani et

al., 2023).

Adhering to the principles advocated by Quality and Safety Education for Nurses

(QSEN) is an evidence-based strategy to enhance patient safety and reduce diagnostic errors. By

integrating QSEN principles, nurses and healthcare professionals can prioritize a culture of

safety, emphasizing continuous improvement and patient-centered care. This involves ongoing

education on critical thinking skills, effective communication, and patient advocacy. A

workforce trained in QSEN principles is better equipped to identify and address diagnostic errors

promptly, contributing to improved patient outcomes and potentially reducing healthcare costs

associated with complications arising from errors (Payangga, 2020).

Encouraging active patient engagement and fostering shared decision-making represent

best-practice strategies to reduce diagnostic errors and associated costs. Informed patients who

actively participate in their healthcare are more likely to provide accurate medical histories and

articulate their concerns effectively. This collaboration between healthcare professionals and

patients facilitates a more comprehensive understanding of symptoms, contributing to accurate

diagnoses. Moreover, when patients are actively involved in decision-making, there is potential

for a more judicious use of healthcare resources, reducing unnecessary tests and procedures and,

consequently, lowering overall healthcare costs (Treichler et al., 2021).

Nurses' Role in Coordinating Care to Increase Patient Safety and Reduce Costs in

Diagnostic Errors

Nurses play a pivotal role in coordinating care by advocating for the availability of

comprehensive patient information. By ensuring accurate and detailed documentation of patients'

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medical histories and symptoms, nurses contribute to a more thorough diagnostic process.

Complete information enables healthcare teams to make informed decisions, reducing the

likelihood of diagnostic errors (Karam et al., 2021). This proactive approach not only enhances

patient safety but also aids in cost reduction by minimizing the need for redundant or

unnecessary diagnostic tests.

Effective communication is paramount in mitigating diagnostic errors, and nurses act as

crucial facilitators in interdisciplinary communication. Nurses can bridge communication gaps

between healthcare team members, ensuring that relevant information is shared promptly and

accurately. Regular team meetings and case conferences organized by nurses foster collaborative

decision-making, enhancing diagnostic accuracy. Improved communication also contributes to

cost reduction by streamlining the diagnostic process and avoiding duplicate or irrelevant tests.

Nurses play a key role in educating and empowering patients, which is essential for

reducing diagnostic errors and associated costs. By providing clear information about the

importance of accurate symptom reporting and the diagnostic process, nurses empower patients

to actively participate in their healthcare. Informed and engaged patients are more likely to

communicate effectively with healthcare professionals, leading to a more accurate diagnostic

assessment. This approach contributes to patient safety and cost reduction by minimizing

unnecessary diagnostic procedures and preventing complications arising from

miscommunication.

Nurses collaborate with various healthcare professionals to ensure a comprehensive and

well-coordinated approach to patient care. By actively participating in multidisciplinary teams,

nurses contribute their expertise and advocate for holistic patient assessments. This collaborative

model promotes a thorough consideration of all relevant factors, reducing the risk of diagnostic
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errors. Additionally, coordination among healthcare professionals enhances resource efficiency,

preventing unnecessary tests or treatments and thereby reducing overall healthcare costs.

Stakeholders for Coordinating Quality and Safety Enhancements in Diagnostic

Errors

Nurses collaborate closely with healthcare providers and specialists involved in the

diagnostic process. This includes physicians, radiologists, pathologists, and other clinicians who

contribute to the diagnostic decision-making. Effective communication and interdisciplinary

collaboration with these stakeholders are essential to ensure a comprehensive and accurate

assessment of patient conditions, minimizing the risk of diagnostic errors and promoting patient

safety.

Coordination with laboratory and imaging technologists is crucial in addressing

diagnostic errors, particularly in the interpretation of test results. Nurses need to communicate

effectively with these stakeholders to clarify specific test requirements, discuss any observed

anomalies, and ensure the timely and accurate reporting of results. Collaborating with laboratory

and imaging teams contributes to the reliability of diagnostic information, reducing the

likelihood of errors in the diagnostic process.

Patients and their families are active participants in the diagnostic process, providing

valuable information about symptoms, medical history, and lifestyle factors. Nurses should

coordinate with patients to gather comprehensive and accurate data, ensuring that all relevant

details are considered during diagnosis. Additionally, educating patients about the importance of

clear communication and their role in the diagnostic process enhances patient engagement,

contributing to improved diagnostic accuracy and safety.

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Active involvement with quality improvement teams and patient safety committees

within healthcare organizations is essential for nurses seeking to drive enhancements in

diagnostic accuracy. These stakeholders focus on developing and implementing strategies to

identify and mitigate factors contributing to diagnostic errors. Collaboration with these teams

allows nurses to contribute insights, share experiences, and participate in initiatives aimed at

continuous improvement in diagnostic practices.

As healthcare systems increasingly rely on technology for diagnostic processes,

coordination with Health Information Technology (HIT) specialists is crucial. Nurses must

collaborate with HIT specialists to ensure the proper functioning of diagnostic tools, electronic

health records (EHRs), and other technologies. This coordination helps in preventing

technological errors, ensuring the accuracy of diagnostic information, and promoting the use of

technology to enhance the diagnostic accuracy and safety.

Conclusion

In conclusion, the reduction of diagnostic errors and the enhancement of patient safety

necessitate a collaborative effort involving key stakeholders, with nurses playing a pivotal role in

orchestrating this coordination. By actively engaging with healthcare providers, specialists,

technologists, patients, quality improvement teams, Health Information Technology specialists,

and regulatory bodies, nurses contribute to a comprehensive and multidisciplinary approach to

diagnostics. Through effective communication and collaboration, nurses ensure the integration of

diverse perspectives, promoting accuracy, transparency, and continuous improvement in

diagnostic processes. This coordinated approach is fundamental to cultivating a healthcare

environment that prioritizes patient safety and fosters a culture of learning and excellence in

diagnostic practices.
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References

Barwise, A., Leppin, A., Dong, Y., Huang, C., Pinevich, Y., Herasevich, S., Soleimani, J., Gajic,

O., Pickering, B., & Kumbamu, A. (2021). What contributes to diagnostic error or delay?

A qualitative exploration across diverse acute care settings in the US. Journal of Patient

Safety, 17(4), 239–248. https://doi.org/10.1097/PTS.0000000000000817

Croskerry, P. (2022). The Rational Diagnostician and Achieving Diagnostic Excellence. JAMA.

https://doi.org/10.1001/jama.2021.24988

Hussain, F., Cooper, A., Carson-Stevens, A., Donaldson, L., Hibbert, P., Hughes, T., & Edwards,

A. (2019). Diagnostic error in the emergency department: learning from national patient

safety incident report analysis. BMC Emergency Medicine, 19(1).

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Karam, M., Chouinard, M.-C., Poitras, M.-E., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon,

C. (2021). Nursing care coordination for patients with complex needs in primary

healthcare: A scoping review. International Journal of Integrated Care, 21(1), 1–21.

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R., Blakeley, J. O., & Plotkin, S. R. (2022). Understanding barriers to diagnosis in a rare,

genetic disease: Delays and errors in diagnosing schwannomatosis. American Journal of

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Payangga, A. D. (2020). Nursing Competency on Safety Practices and Quality Care. Asian

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Sutton, R., & Pincock, D. (2020). An overview of clinical decision support systems: benefits,

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Treichler, E. B. H., Rabin, B. A., Cohen, A. N., & Light, G. A. (2021). How Shared Is Shared

Decision Making? Reaching the Full Potential of Patient-Clinician Collaboration in

Mental Health. Harvard Review of Psychiatry, 29(5), 361–369.

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Zenani, N. E., Sehularo, L. A., Gause, G., & Chukwuere, P. C. (2023). The contribution of

interprofessional education in developing competent undergraduate nursing students:

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