SIDM's priority: Translating ideas into action

Wolford, Robert W. Robert.W.Wolford at OSFHEALTHCARE.ORG
Thu Nov 5 20:17:12 UTC 2015


Perhaps the first module to develop would be directed at faculty development, to give our teachers a solid foundation in critical thinking and to help guide curriculum development on this topic.

Robert W. Wolford, M.D., M.M.M., CMQ
Director of Quality and Process Improvement
Department of Emergency Medicine
OSF Saint Francis Medical Center
530 NE Glen Oak Avenue | Peoria, IL | 61637
Office:  (309) 655-2793

"Serving with the Greatest Care and Love."

From: Marius Laurent [mailto:marius.laurent at SKYNET.BE]
Sent: Thursday, November 5, 2015 9:35 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] SIDM's priority: Translating ideas into action

Pat,
I like your proposition, but I must confess my surprise seeing your affirmation about numerous studies proving the role of thinking failure in diagnosis errors, and about meta-analytic studies demonstrating the efficacy of critical thinking training. I desperately look for such evidences, maybe you can help me?
Marius

De : Pat Croskerry [mailto:croskerry at EASTLINK.CA]
Envoyé : mercredi 4 novembre 2015 21:52
À : IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Objet : Re: [IMPROVEDX] SIDM's priority: Translating ideas into action


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<mailto:mark.graber at IMPROVEDIAGNOSIS.ORG>> wrote:
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.

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.

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.

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.

  Mark

Mark L Graber MD FACP
President, SIDM  www.improvediagnosis.org<http://www.improvediagnosis.org>
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