Children ' s Hospital Colorado is going where few American hospitals dare: the largely unexplored world of diagnostic error.
In this uncharted territory, there are no guidelines to fix the problem. There is little data, and hospitals are really only beginning to understand it.
But it’ s a place the hospital absolutely must go if it is to ever approach its goal of harming zero patients, says Dan Hyman, MD, MMM, Chief Medical and Patient Safety Officer at Children’ s Colorado.
The root of the problem is, for now, intangible. How do you define diagnostic errors? How do you even find them? How do you structure a speculative process that can’ t really be automated?
So unexplored is this territory that no one even knows exactly how many misdiagnoses occur— just that it happens often.
Dr. Hyman and several faculty colleagues at the University of Colorado School of Medicine are leading the initiative based on a hypothesis: By understanding our cognitive biases, we can help each other“ think slowly” and, when necessary, consider other diagnoses. By attempting to create a roadmap to effectively reduce diagnostic errors, Children’ s Colorado is committing to this new initiative— despite the uncertainty that it will produce results.
“ This to me is the next critical transformational strategy,” Dr. Hyman says.“ If we can understand and then reduce the amount of diagnostic error, we’ ll have really changed preventable harm.”
LONGTERM PROGRESS( LAST 3-5 YEARS)
50 %
REDUCTION IN CENTRAL LINE ASSOCIATED-BLOOD STREAM INFECTIONS
50 %
REDUCTION IN PRESSURE INJURIES
50 %
REDUCTION IN PATIENT IDENTIFICATION ERRORS
75 %
REDUCTION IN SURGICAL SITE INFECTIONS
3
IN THE PAST 12 MONTHS, CHILDREN’ S COLORADO FURTHER REDUCED HOSPITAL- ACQUIRED CONDITIONS BY 15 + PERCENT.