Resilient actions in the diagnostic process and system performance.
Smith MW, Giardina TD, Murphy DR, et al. Resilient actions in the diagnostic process and system performance. BMJ Qual Saf. 2013;22(12):1006-13. doi:10.1136/bmjqs-2012-001661.
In this study, primary care providers frequently relied on extraordinary actions to overcome system barriers in obtaining their patients' timely and safe cancer evaluations. This finding provides evidence that downstream measures, such as timeliness of diagnosis, may fail to detect major system problems.