let's share !!

Pat Croskerry croskerry at EASTLINK.CA
Sun Jan 24 15:07:58 UTC 2016


Nicely put. It is important to recognize the different categories of bias. Bias is not a bogey man that we should always avoid - the term encompasses several sub-types, some of which will be beneficial (that's how we evolved with them in the first place) and some will not. Understanding the properties of biases and how they pervade our decision making should be our goal. Critical thinking and strategies for CBM (Cognitive bias mitigation) ultimately appear to be among our best options to improve diagnostic outcomes. 
Pat



-----Original Message-----
From: Campbell, Samuel [mailto:Samuel.Campbell at nshealth.ca] 
Sent: Sunday, January 24, 2016 10:24 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG; 'Pat Croskerry'
Subject: RE: [IMPROVEDX] let's share !!

That is a 'created bias' to counter the recognized one of devaluing the concerns of psych patients, a nice (organic) bias may be the inclination to act quickly with ABC's when someone is rapidly dying in front of you as opposed to trying to get a correct diagnosis??
S.

Samuel G. Campbell
MB BCh, FCFP(EM), Dip PEC(SA), FCCHL.
Professor, Department of Emergency Medicine Dalhousie University Chief, Charles V. Keating Emergency and Trauma Centre Queen Elizabeth II HSC
1796 Summer St,  Halifax, Nova Scotia. B3H 3A7

Ph: 902-473 2020
Fax: 902-473 3617

-----Original Message-----
From: Pat Croskerry [mailto:croskerry at EASTLINK.CA]
Sent: Saturday, January 23, 2016 11:56 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] let's share !!

CDR stands for 'cognitive disposition to respond'. Initially, we adopted the term to try to overcome the negative connotations of 'bias'. Sometimes being biased can be a good thing but there is a general tendency to see bias negatively as in racial bias or obesity bias.
An example of a good bias is the tendency to over-examine and over-investigate psychiatric patients presenting to the emergency department (given there is a tendency to under-examine and under-investigate them). 

_____________________________________________________________
Pat Croskerry MD, PhD
Professor,Department of Emergency Medicine, Director, Critical Thinking Program, Division of Medical Education, Faculty of Medicine, Dalhousie University, QE II - Health Sciences Centre, Halifax Infirmary, Suite 355
1796 Summer Street, Halifax, Nova Scotia, B3H 2Y9 CANADA



-----Original Message-----
From: Samuel, Rana [mailto:Rana.Samuel at VA.GOV]
Sent: Friday, January 22, 2016 12:44 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] let's share !!

CDR???? Critical Diagnostic Reasoning? Confusing Diagnostic Reports? Crazy Doctor Responses??

-----Original Message-----
From: Grubenhoff, Joe [mailto:Joe.Grubenhoff at CHILDRENSCOLORADO.ORG]
Sent: Friday, January 22, 2016 11:09 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [EXTERNAL] Re: [IMPROVEDX] let's share !!

1/2) Not much - I have started teaching peds residents and fellows at the bedside as well as at our morning report conference regarding case-specific CDRs. I am starting work with our hospital's quality and safety team and CQO to start to assess knowledge and attitudes among our faculty regarding heuristics, making mistakes, etc. One thought is to make discussions of CDRs a more prominent, regular feature of M&M in part by reframing them as just another system (the human way of processing information) into which error can creep...

3) No way to measure diagnostic errors, minimal research showing effective in change in behavior in real-world practice setting, cultural reluctance for physicians and advanced-practice providers to reveal much less discuss errors, a common language on which to base discussions.

4) Myself

5) Eh...

Joe Grubenhoff, MD| Assistant Professor of Pediatrics Section of Emergency Medicine | University of Colorado Children's Hospital Colorado
13123 East 16th Avenue, Box 251  |  Anschutz Medical Campus  |  Aurora, CO 80045 | Phone: (303) 724-2581 | Fax: (720) 777-7317 joe.grubenhoff at childrenscolorado.org

Connect with Children's Hospital Colorado on Facebook and Twitter


For a child’s sake…
                We are a caring community called to honor the sacred trust of our patients, families and each other through
                humble expertise, generous service and boundless creativity. 
…This is the moment.


-----Original Message-----
From: Elham Yousef [mailto:yousefe at CCF.ORG]
Sent: Friday, January 22, 2016 6:42 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] let's share !!

Good morning Team,

I would like to ask all of you to share:

1- What have you done so far at your work places ( hospitals, offices, institutions, medical schools, organizations...etc.) to
    improve diagnoses ?

2- How did you start?

3- What are the obstacles/ barriers ?

4- What are your monitoring ?

5-How are you monitoring? 

6 How successful are you so far?

Elham






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




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