"Ten" lists ....

pb mikburger22 at YAHOO.COM
Wed May 1 15:14:52 UTC 2013


 
Telling people to "think better" is a start.
 
To effect this you need to work in a system which;
 
Provides feedback on cases,
Insures difficult clinical problems are discussed within the group, 
Uses technology which primarily helps decision making, 
Properly aligns incentives,
Does not act like a typical corporation in establishing clinical parameters,
Wants providers to think outside the box,
Incorporates students in their clinical practice,
Uses specialists in Informatics and computer/human interaction to help design their
work spaces and flow.
 
Has a funded department whose purpose is to oversee the above and tweak 
as necessary.
 
Paul
 
 
 
 
 
 
 
 


--- On Wed, 5/1/13, David Meyers <dm0015 at ICLOUD.COM> wrote:


From: David Meyers <dm0015 at ICLOUD.COM>
Subject: Re: Quick hello and a reminder or two / "Ten" lists ....
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Date: Wednesday, May 1, 2013, 9:15 AM




Most likely these will suffer the same fate as their biblical counterparts. THIS IS NOT A STRATEGY FOR SUCCESS!

Sent from my iPhone


David L Meyers
410-952-8782

On May 1, 2013, at 9:08 AM, Nonie Leonidas <nonieleonidas68 at GMAIL.COM> wrote:











Below is one Strategy that we can use to reduce diagnostic errors as suggested by Mark L. Graber, "Educational Strategies to Reduce Diagnostic Error: can you teach this stuff?" Adv in Health Sci Educ (2009) 14:63-69 is to keep in mind the:

 


Ten Commandments to Reduce Cognitive Errors
 
1.      Thou shalt reflect on how you think and decide.
2.      Thou shalt not rely on your memory when making critical decisions.
3.      Thou shalt make your working environment information-friendly by using the latest wireless technology such as the iPad, Kindle, Samsung Notes, Nexus.
4.      Thou shalt consider other possibilities even though you are sure of your first diagnosis.
5.      Thou shalt know Bayesian probability and the epidemiology of the diseases in your differential diagnosis.
6.      Thou shalt mentally rehearse common and serious conditions that you expect to see in your specialty.
7.      Thou shalt ask yourself if you are the right person to make the final decision or a specialist after considering the patient’s values and wishes.
8.      Thou shalt take time to decide and not be pressured by anyone.
9.      Thou shalt create accountability procedures and follow up for decisions made.
10.   Thou shalt record in a relational data base software your patient’s problems and decisions for review and improvement.




Leonardo L. Leonidas, MD
Assistant Clinical Professor in Pediatrics (retired 2008)
Distinguished Career Teaching Award, 2009
Tufts University School of Medicine, Boston, USA

 

END



 











 
 
 


 
 
 





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