Improving diagnosis: adding context to cognition.

Mark Linzer; Erin E Sullivan; Andrew P. J Olson; Maram Khazen; Maria M. Mirica; Gordon D Schiff

Commentary

Improving diagnosis: adding context to cognition.

September 7, 2022

Linzer M, Sullivan EE, Olson APJ, et al. Diagnosis (Berl). 2023;10(1):4-8.

View more articles from the same authors.

Challenging working conditions and increased cognitive workload can result in stress and burnout. This article describes a conceptual framework in which working conditions and cognitive workload impact stress and burnout, which, in turn, impacts diagnostic accuracy. Potential uses and testing of the framework are described.

PubMed citation

Free full text

Related Resources From the Same Author(s)

How does work environment relate to diagnostic quality? A prospective, mixed methods study in primary care.

July 12, 2023

Measuring and improving diagnostic safety in primary care: addressing the “twin” pandemics of diagnostic error and clinician burnout.

March 3, 2021

COVID-19: making the right diagnosis.

August 5, 2020

Improving diagnostic performance through feedback: the Diagnosis Learning Cycle.

September 1, 2021

Identifying trigger concepts to screen emergency department visits for diagnostic errors.

December 16, 2020

Human centered design workshops as a meta-solution to diagnostic disparities.

November 2, 2022

Analyzing diagnostic errors in the acute setting: a process-driven approach.

October 20, 2021

Improving diagnostic decision support through deliberate reflection: a proposal.

November 9, 2022

The effects of rudeness, experience, and perspective-taking on challenging premature closure after pediatric ICU physicians receive hand-off with the wrong diagnosis: a randomized controlled simulation trial.

December 9, 2020

The e-Autopsy/e-Biopsy: a systematic chart review to increase safety and diagnostic accuracy.

October 26, 2022

Optimizing Pediatric Patient Safety in the Emergency Care Setting.

October 19, 2022

Real-world virtual patient simulation to improve diagnostic performance through deliberate practice: a prospective quasi-experimental study.

December 15, 2021

Use of a structured approach and virtual simulation practice to improve diagnostic reasoning.

February 23, 2022

A diagnostic time-out to improve differential diagnosis in pediatric abdominal pain.

July 14, 2021

A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts.

December 7, 2022

How insight contributes to diagnostic excellence.

September 21, 2022

Understanding context specificity: the effect of contextual factors on clinical reasoning.

September 2, 2020

Strengths and weaknesses in the diagnostic process of endometriosis from the patients' perspective: a focus group study.

September 15, 2021

Using the Assessment of Reasoning Tool to facilitate feedback about diagnostic reasoning.

January 11, 2023

Antecedent treat-and-release diagnoses prior to sepsis hospitalization among adult emergency department patients: a look-back analysis employing insurance claims data using Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) methodology.

December 8, 2021

Missed acute myocardial infarction in the emergency department-standardizing measurement of misdiagnosis-related harms using the SPADE method.

August 19, 2020

Diagnostic delays in infectious diseases.

September 28, 2022

Bad things can happen: are medical students aware of patient centered care and safety?

January 25, 2023

A pause in pediatrics: implementation of a pediatric diagnostic time-out.

September 14, 2022

The COVID trap: pediatric diagnostic errors in a pandemic world.

August 25, 2021

Rate of sepsis hospitalizations after misdiagnosis in adult emergency department patients: a look-forward analysis with administrative claims data using Symptom-Disease Pair Analysis of Diagnostic Error methodology in an integrated health system.

May 12, 2021

Bringing the clinical laboratory into the strategy to advance diagnostic excellence.

September 22, 2021

Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study.

November 16, 2022

A call to action: next steps to advance diagnosis education in the health professions.

June 8, 2022

Development and usability testing of the Agency for Healthcare Research and Quality Common Formats to capture diagnostic safety events.

May 25, 2022

Using the NAM diagnostic process framework to teach clinical reasoning in computerized case presentations to 251 medical students.

September 9, 2020

Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors.

September 8, 2021

Direct observation of depression screening: identifying diagnostic error and improving accuracy through unannounced standardized patients.

May 1, 2020

From principles to practice: embedding clinical reasoning as a longitudinal curriculum theme in a medical school programme.

June 15, 2022

Association of patient and family reports of hospital safety climate with language proficiency in the US.

June 29, 2022

Stroke hospitalization after misdiagnosis of "benign dizziness" is lower in specialty care than general practice: a population-based cohort analysis of missed stroke using SPADE methods.

July 21, 2021

Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016

March 3, 2017

Urgent referrals from primary care to dermatology for lesions suspicious for skin cancer: patterns, outcomes, and need for systems improvement.

December 7, 2022

Diagnostic error in pediatrics: a narrative review.

March 23, 2022

Personal formularies of primary care physicians across 4 health care systems.

August 4, 2021

A survey of outpatient internal medicine clinician perceptions of diagnostic error.

February 5, 2020

Pursuit of "endpoint diagnoses" as a cognitive forcing strategy to avoid premature diagnostic closure.

December 21, 2022

Improving diagnosis by feedback and deliberate practice: one-on-one coaching for diagnostic maturation.

June 2, 2021

Potentially harmful medication dispenses after a fall or hip fracture: a mixed methods study of a commonly used quality measure.

March 9, 2022

Evaluation of feedback modalities and preferences regarding feedback on decision-making in a pediatric emergency department.

July 6, 2022

Extended work shifts and neurobehavioral performance in resident-physicians.

March 10, 2021

Association of diagnostic stewardship for blood cultures in critically ill children with culture rates, antibiotic use, and patient outcomes: results of the Bright STAR Collaborative.

May 18, 2022

An estimate of missed pediatric sepsis in the emergency department.

June 2, 2021

National improvements in resident physician-reported patient safety after limiting first-year resident physicians' extended duration work shifts: a pooled analysis of prospective cohort studies.

May 25, 2022

Effects of state opioid prescribing laws on use of opioid and other pain treatments among commercially insured U.S. adults.

March 30, 2022

Discrepancy between emergency department admission diagnosis and hospital discharge diagnosis and its impact on length of stay, up-triage to the intensive care unit, and mortality.

February 16, 2022

Delayed diagnosis of serious paediatric conditions in 13 regional emergency departments.

October 26, 2022

Defining diagnostic error: a scoping review to assess the impact of the National Academies' report Improving Diagnosis in Health Care.

May 25, 2022

Effects on resident work hours, sleep duration and work experience in a Randomized Order Safety Trial Evaluating Resident-physician Schedules (ROSTERS).

June 26, 2019

Emergency medicine physicians' perspectives on diagnostic accuracy in neurology: a qualitative study.

July 6, 2022

The safety of emergency care systems: results of a survey of clinicians in 65 US emergency departments.

March 4, 2009

The National Emergency Department Safety Study: study rationale and design.

January 9, 2008

Where trust flourishes: perceptions of clinicians who trust their organizations and are trusted by their patients.

January 12, 2022

Improving Education—A Key to Better Diagnostic Outcomes.

March 30, 2022

Enabling a learning healthcare system with automated computer protocols that produce replicable and personalized clinician actions.

August 4, 2021

Health Professions Education.

June 12, 2019

Operational measurement of diagnostic safety: state of the science.

October 7, 2020

A prescription for enhancing electronic prescribing safety.

December 12, 2018

Clinical reasoning in the wild: premature closure during the COVID-19 pandemic.

August 19, 2020

Automated identification of diagnostic labelling errors in medicine.

June 8, 2022

A clinical reasoning curriculum for medical students: an interim analysis.

June 22, 2022

Indication alerts to improve problem list documentation.

January 26, 2022

Nursing implications of an early warning system implemented to reduce adverse events: a qualitative study.

May 11, 2022

The Lancet Commission on lessons for the future from the COVID-19 pandemic.

October 12, 2022

Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network--13 academic medical centers, April-June 2020.

September 23, 2020

Affective influences on clinical reasoning and diagnosis: insights from social psychology and new research opportunities.

October 19, 2022

Improving discharge safety in a pediatric emergency department.

October 26, 2022

Team cognition in handoffs: relating system factors, team cognition functions and outcomes in two handoff processes.

June 22, 2022

Diagnostic error as a result of drug-laboratory test interactions.

March 6, 2019

Developing the Safer Dx Checklist of Ten Safety Recommendations for Health Care Organizations to address diagnostic errors.

October 12, 2022

Maybe they had a bad day: how LGBTQ and BIPOC patients react to bias in healthcare and struggle to speak out.

September 14, 2022

Effect of different interventions to help primary care clinicians avoid unsafe opioid prescribing in opioid-naive patients with acute noncancer pain: a cluster randomized clinical trial.

September 7, 2022

Should electronic differential diagnosis support be used early or late in the diagnostic process? A multicentre experimental study of Isabel.

October 27, 2021

COVID blindness.

August 5, 2020

Patient perceptions of misdiagnosis of endometriosis: results from an online national survey.

July 29, 2020

Narrowing the mindware gap in medicine.

July 20, 2022

Preventing home medication administration errors.

March 14, 2022

Adding automation and independent dual verification to reduce wrong blood in tube (WBIT) events.

September 28, 2022

RaDonda Vaught, medication safety, and the profession of pharmacy: steps to improve safety and ensure justice.

August 17, 2022

The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study.

August 15, 2007

Trends in adverse event rates in hospitalized patients, 2010-2019.

July 27, 2022

Accuracy of practitioner estimates of probability of diagnosis before and after testing.

May 5, 2021

Effect on patient safety of a resident physician schedule without 24-hour shifts.

July 15, 2020

Teamwork before and during COVID-19: the good, the same, and the ugly….

August 24, 2022

Evaluating a patient safety learning laboratory to create an interdisciplinary ecosystem for health care innovation.

July 13, 2022

There's no place like home--integrating a pharmacist into the hospital-in-home model.

March 17, 2021

The critical need for nursing education to address the diagnostic process.

February 17, 2021

Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update.

June 22, 2022

February 2, 2022

Using social and behavioural science to support COVID-19 pandemic response.

June 3, 2020

Challenges with implementing the Centers for Disease Control and Prevention opioid guideline: a consensus panel report.

April 3, 2019

Multilevel factors associated with time to biopsy after abnormal screening mammography results by race and ethnicity.

July 6, 2022

Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial.

August 18, 2021

Rates of surgical consultations after emergency department admission in Black and White Medicare patients.

October 26, 2022

Families as partners in hospital error and adverse event surveillance.

March 8, 2017

Related Resources

Making Healthcare Safer IV: A Continuous Updating of Patient Safety Harms and Practices.

April 22, 2024

On Patient Safety.

January 13, 2024

A proposed approach to allegations of sexual boundary violation in health care.

December 13, 2023

Challenge Competition: Impact of Patient Safety Tools.

December 12, 2023

Community Health Systems’ ongoing journey to zero preventable harm.

December 6, 2023

Five strategies for a safer EHR modernization journey.

December 6, 2023

Interview

In Conversation with... Cheryl Jones about Addressing Workplace Violence and Creating a Safer Workplace

October 31, 2023

Perspectives on Safety

Addressing Workplace Violence and Creating a Safer Workplace

October 31, 2023

WebM&M Cases

“Copy and Paste” Notes and Autopopulated Text in the Electronic Health Records

October 31, 2023

Toxic leadership and its relationship with outcomes on the nursing workforce and patient safety: a systematic review.

October 25, 2023

Bringing the equity lens to patient safety event reporting.

October 25, 2023

Right Kind of Wrong: Why Learning to Fail can Teach us to Thrive.

October 18, 2023

Abbreviation use decreases effective clinical communication and can compromise patient safety.

October 4, 2023

Why admitting to mistakes can help doctors (and patients).

October 4, 2023

Smart Healthcare Safety.

October 4, 2023

Fragmented: A Doctor's Quest to Piece Together American Health Care.

September 27, 2023

Wake-up call: night shifts adversely affect nurse health and retention, patient and public safety, and costs.

September 20, 2023

Global Knowledge Sharing Platform for Patient Safety.

September 20, 2023

In search of an international multidimensional action plan for second victim support: a narrative review.

September 13, 2023

Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety.

August 16, 2023

Patient, carer and family experiences of seeking redress and reconciliation following a life-changing event: systematic review of qualitative evidence.

August 2, 2023

Sociotechnical work system approach to occupational fatigue.

July 26, 2023

Lessons for Work-Life Wellness in Academic Medicine: Parts 1-3.

July 26, 2023

Maternal Health of Women and Girls of African Descent in the Americas.

July 26, 2023

Disclosing medical errors: prioritising the needs of patients and families.

July 5, 2023

Measurement and Monitoring of Safety Framework (MMSF): learning from its implementation in Canada.

June 28, 2023

Context matters: toward a multilevel perspective on context in clinical reasoning and error.

June 21, 2023

Patient Safety Primers

Strategies to Improve Organizational Health Literacy.

May 31, 2023

Roadmap to Health Care Safety for Massachusetts.

May 3, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

See More About The Topic

Hospitals

Long-Term Care

Ambulatory Clinic or Office

Quality and Safety Professionals

Safety Scientists

Improving diagnosis: adding context to cognition.

Strategies to Improve Organizational Health Literacy.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Improving diagnosis: adding context to cognition.

Strategies to Improve Organizational Health Literacy.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site