Diagnostic decisions: Interventions for safer diagnoses
OTTAWA, August 16, 2021—The Canadian Medical Protective Association (CMPA) held its annual meeting today, followed by an accredited education session for physicians titled Diagnostic Decisions: Interventions for Safer Diagnoses.
The session featured a panel of CMPA experts and focused on medico-legal and patient safety issues concerning diagnostic decision-making. It was designed to help physicians identify risks associated with diagnostic decision-making and implement practical approaches to prevent patient harm.
The CMPA’s analyses of patient safety incidents and medico-legal case files reveal that deficiencies in diagnostic reasoning contribute to serious patient harm. These are often linked to inadequate clinical assessments, loss of situational awareness, and team communication breakdowns.
“This year’s education session is informed by CMPA data involving failures in diagnostic reasoning,” said Dr. Lisa Calder, CEO of the CMPA. “Interventions that enhance and support cognitive reasoning processes raise situational awareness and improve team communication. This is key to reducing the risk of serious patient harm related to clinical care.”
The frequency of diagnostic error in all CMPA legal actions, College, and hospital complaints is approximately 21%, based on an analysis of 17,278 closed case files over a five-year period. Of these cases, 87% featured a delayed diagnosis or a misdiagnosis in which experts were critical of the treating physician's assessment of the patient.
"Physicians strive to make the correct diagnosis while frequently contending with numerous complicating factors,” said Dr. Calder. “Consequently, having a structured approach to collecting and evaluating information is crucial to arriving at the right diagnosis.”
Diagnostic error is an inherent risk of clinical practice. It arises from system, team and individual factors that are often intertwined. Fortunately, approaches such as pausing to reflect on a differential diagnosis, leveraging the expertise of the team and implementing reliable systems can promote safer diagnostic decisions.
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About the CMPA
The CMPA delivers efficient, high quality physician-to-physician advice and assistance in medico-legal matters, including the provision of appropriate compensation, on behalf of our members, to patients injured by negligent medical care (fault in Québec). Our evidence-based products and services enhance the safety of medical care, reducing unnecessary patient harm and healthcare costs.
As Canada’s largest physician organization and with the support of our over 104,000 physician members, the CMPA collaborates, advocates, and effects positive change on important healthcare and medico-legal issues. The Association is governed by an elected Council of physicians.