In a recent blog post, we wrote about the recent study that revealed that 12,000,000 people are affected by diagnostic errors each year. While that is an alarming statistic, it’s important to respond to that by focusing attention on solutions to this problem. That very topic was the focus of discussion and research at the University of California at San Francisco’s IHI Open School Chapter. The school paper reported, “At the last meeting of UCSF’s Institute for Healthcare Improvement (IHI) Open School on March 11, Dr. Catherine Lucey, professor and vice dean of education at the UCSF School of Medicine explained how errors that occur in the healthcare setting parallel those of everyday life, and spoke about the common cognitive causes that turn activities into errors.
Consider the driving example. The routine steps involved are ingrained in our brains as a pre-packaged set of instructions and actions called a schema, which help us arrive at a given endpoint, in this case, our destination. If one day you are supposed to pick up a gallon of milk on your way home, you are likely to forget because this schema would kick in. Preventing this error, or “slip,” would require more monitoring and reminders to achieve the desired outcome— milk and arriving safely at the correct location.
In a similar manner, Dr. Lucey discussed having a “designated skeptic” or “designated curmudgeon” on each medical team who would catch potential cognitive biases that can sway our thinking in one direction or another. The aim is to move the team towards cognitive thinking to aid the decision-making process, thus preventing medical errors. This person could be anyone, and what better person than you—the student? You can reduce medical errors and save lives by constantly questioning everything and applying your developing knowledge base.” This may be worth consideration as an addendum to the highly-touted checklist system. If healthcare professionals are able to break habits and routines, it may just prevent misdiagnoses and medical errors.
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