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Cognitive biases are ways in which a particular person understands events, facts, and other people based on their own set of beliefs and experiences, which may or may not be reasonable or accurate. People are often unaware of the influence of their cognitive biases. Examples of common cognitive biases include:
- Confirmation bias (e.g., neglecting evidence that goes against your belief); anchoring bias (prioritizing information/data that supports one’s initial impressions);
- Framing bias (the manner by which data are presented);
- Authority bias (when a higher authority provides information);
- Affect heuristic (when actions are swayed by emotion versus rational decisions).
Cognitive bias impacts patient safety in a variety of ways. For example, cognitive biases can lead to diagnostic errors because they disrupt physicians’ and advanced practice providers’ processes to gather and interpret evidence and take appropriate actions. Authority bias is common in healthcare; for example, nurses tend to accept opinions of physicians on face value.
Closed loop communication consists of exchanging clear, concise information, and acknowledging receipt of the information to confirm its understanding. The communication is addressed to a specific person on the clinical team by name and the recipient repeats the message back to the sender. Such communication enhances patient safety by preventing confusion, ensuring that teams operate under a shared mental model, and that a specific person is responsible for completing the task.
Burnout is a syndrome of emotional exhaustion, depersonalization, and decreased sense of accomplishment at work that results in overwhelming symptoms of fatigue, exhaustion, cynical detachment, and feelings of ineffectiveness. Burnout among health care professionals is widely understood as an organizational problem in health care that needs to be addressed and has been associated with increased patient safety incidents, including medical errors, reduced patient satisfaction, and poorer safety and quality ratings.