An organisational approach to improving diagnostic safety
Ian A. Scott A B * and Carmel Crock C D
+ Author Affiliations
- Author Affiliations
A Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Ipswich Road, Brisbane, Qld 4102, Australia.
B University of Queensland, Qld, Australia.
C Emergency Department, Royal Victorian Eye and Ear Hospital, Melbourne, Vic., Australia.
D University of Melbourne, Vic., Australia.
* Correspondence to: ian.scott@health.qld.gov.au
Australian Health Review 47(3) 261-267 https://doi.org/10.1071/AH22287
Submitted: 15 December 2022 Accepted: 3 March 2023 Published: 27 March 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Diagnostic error affects up to 10% of clinical encounters and is a major contributing factor to 1 in 100 hospital deaths. Most errors involve cognitive failures from clinicians but organisational shortcomings also act as predisposing factors. There has been considerable focus on profiling causes for incorrect reasoning intrinsic to individual clinicians and identifying strategies that may help to prevent such errors. Much less focus has been given to what healthcare organisations can do to improve diagnostic safety. A framework modelled on the US Safer Diagnosis approach and adapted for the Australian context is proposed, which includes practical strategies actionable within individual clinical departments. Organisations adopting this framework could become centres of diagnostic excellence. This framework could act as a starting point for formulating standards of diagnostic performance that may be considered as part of accreditation programs for hospitals and other healthcare organisations.
Keywords: diagnosis, errors, framework, organisation, performance, program, safety, standards.
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