Getting an accurate and timely diagnosis is fundamental to effective healthcare. It serves as the bedrock upon which all subsequent medical decisions and treatments are based. The diagnostic process itself is intricate, demanding collaboration, clinical expertise, and meticulous information gathering to pinpoint a patient’s health issue. However, despite advancements in medical science, diagnostic errors – defined as diagnoses that are inaccurate or delayed – remain a significant problem across all healthcare settings, causing harm to a substantial number of individuals.
The landmark report, Improving Diagnosis in Health Care, from the Institute of Medicine (IOM), now the National Academy of Medicine, sheds light on this critical issue. This report, building upon previous influential publications like To Err Is Human and Crossing the Quality Chasm, emphasizes that diagnostic errors have been largely overlooked in broader efforts to enhance healthcare quality and safety. The report underscores that most individuals are likely to experience at least one diagnostic error in their lifetime, with consequences ranging from delayed or inappropriate treatment to psychological and financial burdens. In severe cases, these errors can have devastating health outcomes.
The committee behind the Improving Diagnosis in Health Care report firmly concluded that enhancing the diagnostic process is not just feasible but is a moral, professional, and public health imperative. Without a focused and concerted effort to improve diagnosis, the problem of diagnostic errors is expected to worsen. This is due to the increasing complexity of healthcare delivery and the diagnostic process itself, driven by factors such as expanding medical knowledge, technological advancements, and evolving patient demographics.
Just as the diagnostic process requires teamwork, improving diagnosis demands collaboration and a shared commitment to change from all stakeholders in the healthcare ecosystem. This includes healthcare professionals across all disciplines, healthcare organizations and leadership, patients and their families, medical researchers, and policymakers at local and national levels. The recommendations put forth in Improving Diagnosis in Health Care are intended to fuel the growing movement towards prioritizing and improving diagnostic accuracy and timeliness as a cornerstone of healthcare quality and patient safety.
This comprehensive report delves into various facets of the diagnostic process and diagnostic errors. It offers a roadmap for improvement, addressing key areas such as enhancing patient engagement, reforming healthcare professional education and training, leveraging technology effectively, fostering organizational learning and culture change, and reshaping the external environment through reporting mechanisms, medical liability reform, and payment models. By highlighting the urgency and outlining actionable recommendations, Improving Diagnosis in Health Care serves as a crucial resource for anyone committed to making healthcare safer and more effective for all.
Suggested citation:
National Academies of Sciences, Engineering, and Medicine. 2015. Improving diagnosis in health care. Washington, DC: The National Academies Press.
