(SALT LAKE CITY)—It's unknown how many errors are made diagnosing medical diseases and conditions each year, but research has shown that such mistakes contribute to approximately 10 percent of patient deaths and account for 6 percent to 17 percent of adverse hospital events, 根据… 报告 来自美国国家科学院, 工程, 和医学（原医学研究所）.
Diagnostic errors occur often enough that just about everyone receiving medical care will be misdiagnosed at some point. Some of those errors–which the 报告 defines as an inaccurate or delayed diagnosis and the failure to communicate that to the patient–will be minor; others errors will be life threatening and cause irreversible damage. 例如，a video accompanying the 报告 tells the story of a woman whose heart attack was misdiagnosed as acid reflux. The video also describes the story of a man who now lives with cerebral palsy because his jaundice went untreated as a newborn despite pleas by his parents for treatment.
The problem with misdiagnoses such as these is likely to get worse unless the health care profession makes urgent changes, 根据报告, 名为“改善医疗保健诊断”."
A nationwide panel comprising 21 physicians and researchers studied the issue of diagnostic errors and issued the 报告, with eight multifaceted recommendations to address the problem. 小组成员 迈克尔·科恩，文学硕士.D., 教授 病理 犹他大学医学院的教授, says the first recommendation–facilitating effective teamwork among health care providers and patients and their families–is an essential part of the solution. 团队合作, 虽然, depends on something that sounds obvious but doesn't always occur: providers communicating diagnoses to patients.
"Making the changes needed to eliminate diagnostic errors will be difficult and require a team effort,科恩说. "The patient and his or her family are part of the team—and the patient is at the middle of it all."
While communication is something that providers can and must address themselves, 导致诊断错误的其他问题是系统性的, 据科恩说. The panel recommended tackling those issues in several ways, including:
- Developing a culture in which providers can disclose and learn from diagnostic errors without a punitive climate
- Establishing a work system that supports the diagnostic process and improvements in diagnostic performance
- 开发和部署识别的方法, learn from and reduce diagnostic errors and near misses in clinical practice
- Develop a 报告ing environment and medical liability system that facilitates improved diagnosis by learning from diagnostic errors and near misses
- Designing a payment and care delivery environment that supports the diagnostic process
One reason it's hard to know how many diagnostic errors occur is that providers are reluctant to 报告 them for fear of liability. That's why it's important to encourage transparency by addressing the medical liability system and creating an environment that gives providers the incentive voluntarily 报告 diagnostic errors. “如果你有办法以一种公开的方式报道这些, 大发娱乐都可以从这些错误中吸取教训,科恩说. “如果你试图隐藏它们，没有人会从中吸取教训."
除了系统性的变化, the panel made two other recommendations: enhancing the way health care professionals are trained in patient diagnosis and ensuring that health information technologies support patients and providers in the diagnostic process.
The University of Utah is addressing the education component by providing multidisciplinary training in which students all health sciences students–future nurses, 药剂师, therapists and physicians–train together not only to enhance teamwork but to learn the diagnostic process. The 报告 particularly cites nurses as potentially having a larger role in that process.
Cohen cited access to electronic medical records (EMRs) as an example of how health information technologies could better support the diagnostic process. 如果有人去了急诊室, 例如, having access to the patient's EMR can aid a physician in diagnosing the problem. 目前, 然而, 电子病历是个人医疗保健系统的专利, meaning providers who aren't part of a patient's network can't access their records. But having technology that would allow that access could improve the accuracy of a diagnosis in an emergency situation, 科恩说,.
"Improving Diagnosis in Health Care" is the continuation of earlier Institute of Medicine 报告s including "To Err Is Human: Building a Safer Health System,《大发体育官网》st Century" and "Preventing Medication Errors"–that also examined health care issues.
The current study was sponsored by the Agency for Healthcare 研究 and Quality, 疾病控制和预防中心, 美国放射学会, 美国临床病理学会, 谨慎病人基金会, 美国病理学家学会, 医生公司基金会, 珍妮特和巴里·朗, Kaiser Permanente National Community Benefit Fund at the East Bay Community Foundation, 罗伯特·伍德·约翰逊基金会.
报告完成后, 科恩说, the committee now hopes the sponsoring organizations and other health care groups and the public will follow up on it. "We hope they'll become sufficiently interested to bring it to attention and lead to change."