Finding a single solution to prevent physicians' diagnostic errors is unlikely, according to a recently published study. Diagnostic errors that lead to patient harm appear to result from "the alignment of multiple breakdowns," and these breakdowns are caused by a confluence of factors, according to a study in the Oct. 3 edition of Annals of Internal Medicine. The findings led researchers to conclude that "the prospects for `silver bullets' in this area seem remote."
Four malpractice insurance companies participated in the study and provided a random sample of 307 claims alleging injury caused by missed or delayed diagnosis. The authors found that 59% involved diagnostic errors with a median of three process breakdowns per error. Two or more clinicians were involved in 43% of the cases. The report states that poor documentation, scheduling problems and miscommunication played a role in the errors, and it added that these findings reinforce the need for system interventions that reduce reliance on memory, force consideration of alternative diagnostic plans or second opinions, and provide clinical-decision support systems.