SIDM's priority: Translating ideas into action

Pat Croskerry croskerry at EASTLINK.CA
Wed Nov 4 20:52:16 UTC 2015


 
Mark: these all look worthwhile
initiatives.
 
 
 
I’d like to add a further one: given that a
number of studies now point to a significant proportion of diagnostic failure
being due to thinking failures, and given that meta-analytic studies demonstrate
conclusively that by far the most effective way of improving reasoning and
problem solving skills is through critical thinking interventions, I advocate
for the introduction of critical thinking interventions at UGME and PGME. Others
have already designated critical thinking as a meta-competency and some
programs have embarked on this in separate initiatives.  Others in the ethics domain have strongly
proposed that this be done as an ‘ethical imperative’, and, given the unacceptably
high estimates of preventable deaths from diagnostic failure it’s hard to argue
with that.
 
 Rather
than each inventing our own wheels, how about developing a generic Critical
Thinking Module that would be available off the shelf that medical educators
could use? The content could be approved by a consensus committee. This would
be an inexpensive project with potentially high returns.
 
Pat
  
 

On 11/04/15 12:43 PM, Mark Graber  <mark.graber at IMPROVEDIAGNOSIS.ORG> wrote:
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> With the IOM report now officially out on the street, SIDM is now focused on how to change practice to improve diagnosis. The "Coalition to Improve Diagnosis" will be our first priority; the Coalition steering committee has had several meetings already, and the next steps are for each organization to identify at least one action they can take, and for all the members to agree on a common action. The Coalition will also be growing very soon to include another set of key national organizations.
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> We are also urging federal agencies to step up to the plate. Founding Board member David Newman-Toker represented SIDM at a meeting yesterday of the AHRQ National Advisory Committee, and publicly thanked AHRQ for being a key supporter of our efforts through funding of our Diagnostic Error Conferences, the IOM report itself, and through the new R01 and R18 grant funding to study diagnostic error they have recently made available. We asked the NAC to support 3 initiatives deriving from the IOM report: 1) Developing a Common Format for organizations to report diagnostic errors to their Patient Safety Organizations; 2) Working with DOD, HHS, VA and others to develop the national research priorities for diagnosis, and to develop a public-private partnership to promote research; and 3) Providing dedicated funding for AHRQ to support research on diagnostic error in proportion to the harm associated with diagnostic error.
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> Later this month I'll be addressing a group at the CDC to emphasize the actions we'd like to see them take: 1) Resurrect the clinical pathologist position by providing funding for this type of consultation; 2) Resuscitate autopsies at key designated centers as a way to learn about errors; 3) Help develop and use failsafe procedures for test reporting; and 4) Use second opinions in anatomic pathology. 
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> We'll provide updates on these activities as they come up, and would love to hear about initiatives that the listserv readership might also know about, or be involved with.
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>  Mark
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>  Mark L Graber MD FACP
> President, SIDM www.improvediagnosis.org(http://www.improvediagnosis.org)
> 919 990-8497
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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