IMPROVING DIAGNOSIS: STARTING A LOCAL STRATEGY

Monday, October 25, 2010
Vide Lobby (Sheraton Centre Toronto Hotel)
Lorenzo Alonso, Facultad DE Medicina DE MÁlaga (MEDICAL SCHOOL), Malaga, Spain, Jose Luis Escolar, Facultad DE Medicina Malaga(MEDICAL SCHOOL), Malaga, Spain, Pedro Valdivielso, Facultad DE Medicina Malaga (MEDICAL SCHOOL), Malaga, Spain and Miguel Angel Sanchez Chaparro, Facultad DE Medicina Malaga (MEDICAL SCHOOL), MÁlaga, Spain

Statement of problem: The Patient Safety movement has shown that Diagnostic errors can be very harmful for patients but at the same time highly preventable. However, in comparison to other aspects such as medication errors, the implementation of a global strategy to reduce this problem is quite undetermined yet. We started a local strategy with this goal,  at The Hospital Universitario of Málaga, ruled by Servicio Andaluz de Salud.

Description of the intervention or program: The action plan was elaborated for medical specialties using: 1.Educational meetings: oriented to disseminated concepts about  Patient Safety and specifically for Diagnostic errors and the main cognitive bias. 2. Clinical cases: selected from real cases and analyzing the cognitive bias involved in the diagnostic error. 3. Publications: we developed a brochure in spanish about the theoretical concepts related to diagnostic errors. 4. A Web page ( www.foro-osler.com) has been developed also.

Findings to date: : after one year activity doctors and residents are aware about patient safety concepts. When clinical cases are analyzed in terms of detecting bias, people manifest a very favourable impression. Most of the people are reluctant to examine a proper case. Residents and junior doctors are less motivated in comparison to doctors with a longer practice.

Lessons learned: a program about diagnostic problems based in the everyday practice is interesting for doctors. Usually a minority of practitioners attends these meetings but the dissemination is wider. The strategy for junior doctors must be based in practical concepts and must be engaged in the classical session with descriptive clinical cases. Practical tools for analysis are in our opinion the key for success.