Doctors Company Foundation Grant - Great News

Robert L Wears, MD, MS, PhD wears at UFL.EDU
Mon Jun 22 23:21:53 UTC 2015


Even worse ...

how is the cognitive state of someone acting in what later is determined to be an 'error' 
different from that of someone doing normal work in a complex setting?

I don't think framing diagnostic failures (which certainly occur) in terms of 'error' (determined 
after the fact) is a constructive approach.

bob


On 22 Jun 2015 at 9:06, Ross Koppel wrote:

> But, but, but....
> 
> Most errors are unknown and very hard to discover.  Many errors are
> never discovered....ever.
> 
> While I love the design.... the limitations must be acknowledged!
> 
> -- 
> Ross Koppel, PhD FACMI(and professor of research methods for the last
> 30 years) Sociology Department & School of Medicine & Senior Fellow,
> LDI Wharton School UNIVERSITY OF PENNSYLVANIA
> 
> 
> 
> On 6/21/2015 6:21 PM, robert bell wrote:
> > Good news.
> >
> > Well done Mark and team.
> >
> > Jimn, I agree that most errors are ridiculous mistakes and many very
> > simple and not complex. I may be wrong but I think that the serious
> > problems of of the Swiss Cheese phenomena (multiple errors that
> > compound the original problem) could be stopped/helped if the simple
> > things were corrected and less frequent.
> >
> > I would love to see a study, in about 30 - 50 Doctor´s private
> > offices, where there was a 3 month collection run-in period where
> > all the errors that occur are recorded, following interviews with
> > all members of staff (things like no patient call backs for lab and
> > procedures undertaken, switched EKG leads, wrong or delayed
> > diagnoses, forgotten day-before appointment calls, medication
> > refills not called into the pharmacy, etc.). Then randomly give
> > differing instructions to two or three groups of the offices
> > (perhaps different kinds of check lists used at different times) and
> > then seeing what happens to the error rates.
> >
> > Would welcome thoughts on a better structure for such a study to
> > help ensure a better and acceptable outcome.
> >
> > Would litigation issues prevent such a study from ever being
> > undertaken?
> >
> > Once the private offices are "sorted out," then we could better move
> > to medical education and the hospitals!! Or perhaps do them all at
> > once? Would understanding the simple things better would provide a
> > better foundation for other initiatives?
> >
> > Rob Bell, M.D.
> >
> >
> >
> >
> >
> >
> >> On Jun 21, 2015, at 11:45 AM, James Navin 
> >> <0000000581520482-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG 
> >> <mailto:0000000581520482-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>>
> >> wrote:
> >>
> >> Sounds very good. Most errors are ridiculous mistakes  and everbody
> >> makes them .Having been in court over 300 times and innumerable
> >> depos I think I Have seen about everything but actually know that
> >> isn't true either jimn -----Original Message----- From: Mark Graber
> >> <mark.graber at IMPROVEDIAGNOSIS.ORG
> >> <mailto:mark.graber at IMPROVEDIAGNOSIS.ORG>> To: IMPROVEDX
> >> <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> >> <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>> Sent: Sat, Jun 20,
> >> 2015 12:37 pm Subject: [IMPROVEDX] Doctors Company Foundation Grant
> >> - Great News
> >>
> >> The Society to Improve Diagnosis in Medicine (SIDM) is proud 
> >> to announce today a new $200,000 grant from The Doctors Company
> >> Foundation (DCF), awarded to SIDM and our partner, Med-U to improve
> >> diagnosis by providing novel training modules on clinical
> >> reasoning. These scenario-based modules represent the first formal
> >> educational products to specifically address diagnostic error in
> >> the US.  By taking advantage of the stature and scope of the Med-U
> >> educational platform, we have the opportunity to reach a
> >> substantial portion of US medical trainees. Each module will be
> >> incorporated into the Med-U educational platform and used across
> >> the country for 3rd and 4th year medical students.  The modules
> >> will introduce the cognitive biases that lead to errors in clinical
> >> reasoning, how to avoid these pitfalls, and how to recognize and
> >> discuss diagnostic errors encountered in everyday patient care, all
> >> with the goal of improving diagnosis in practice. The project will
> >> be directed by Doctors Andrew Olsen, Gurpreet Dhaliwal, and Bob
> >> Trowbridge, in addition to members of the SIDM Education Committee,
> >> along with key staff from Med-U, including Doctors Leslie Fall and
> >> Valerie Lang, national experts on developing state-of-the-art
> >> teaching modules. My thanks and appreciation to the project team -
> >> we are all looking forward to these first forays in developing the
> >> curriculum we need to improve diagnosis.
> >>
> >>
> >> Mark L Graber, MD FACP
> >> President, SIDM
> >>
> >>
> >>
> >>
> >>
> >>
> >>
> >>
> >> -------------------------------------------------------------------
> >> -----
> >>
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> >>
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> >> Moderator:David Meyers, Board Member, Society for Improving
> >> Diagnosis in Medicine
> >>
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> >> http://www.improvediagnosis.org/
> >>
> >> -------------------------------------------------------------------
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> >>
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> >>
> >>
> >> Moderator:David Meyers, Board Member, Society for Improving
> >> Diagnosis in Medicine
> >>
> >> To learn more about SIDM visit:
> >> http://www.improvediagnosis.org/
> >>
> >
> > As of 1.1.2015 my new email address is: rmsbell200 at yahoo.com 
> > <mailto:rmsbell200 at yahoo.com>
> >
> > Please update your address books accordingly
> >
> >
> > --------------------------------------------------------------------
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> >
> > Visit the searchable archives or adjust your subscription at: 
> > http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
> > Moderator:David Meyers, Board Member, Society for Improving
> > Diagnosis in Medicine
> >
> > To learn more about SIDM visit:
> > http://www.improvediagnosis.org/ 
> 
> 
> 
> 
> 
> 
> 
> Moderator: David Meyers, Board Member, Society to Improve Diagnosis in
> Medicine
> 
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> 

Robert L Wears, MD, MS, PhD
University of Florida  	Imperial College London
wears at ufl.edu		r.wears at imperial.ac.uk
1-904-244-4405 (ass't)  	+44 (0)791 015 2219
Badly designed systems run at the margin of failure
cannot be called unforeseen disasters.






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine




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