let's share !!

Mayer, Thom tmayer at BEST-PRACTICES.COM
Sun Jan 24 19:16:26 UTC 2016


As I hope we all recognize, Pat has been one of the wisest voices who has created the very taxonomy needed to understand these complex issues

Best,
Thom

Thom A. Mayer, MD, FACEP, FAAP
Founder and CEO
[BP]



From: Pat Croskerry [mailto:croskerry at EASTLINK.CA]
Sent: Sunday, January 24, 2016 10:18 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] let's share !!

My own ‘disposition’ is to know as much about biases as possible, to understand their origins, and to give them their rightful names.
A Chinese proverb says that you cannot get to know something unless it has a name.
Carl Linnaeus’ initial efforts to classify all living things gave us the taxonomy and understanding we have to-day.
It can get confusing and babel-like when people give different names for the same thing.
Pat

From: DR WILLIAM CORCORAN [mailto:williamcorcoran at sbcglobal.net]
Sent: Sunday, January 24, 2016 10:39 AM
To: Society to Improve Diagnosis in Medicine; Pat Croskerry
Subject: Re: [IMPROVEDX] let's share !!

Is the term CDR really helpful? Or is it more of our tower of babel?

The beginning of wisdom is to call things by their right names.

Confucian Wisdom

More at http://en.wikipedia.org/wiki/Rectification_of_names

Take care,

Bill Corcoran


William  R. Corcoran, Ph.D., P.E.
21 Broadleaf Circle
Windsor, CT 06095-1634
860-285-8779
William.R.Corcoran at 1959.USNA.com<mailto:William.R.Corcoran at 1959.USNA.com>
http://www.linkedin.com/in/williamcorcoranphdpe
https://www.box.com/shared/kfxg1lt9dh

On Saturday, January 23, 2016 9:35 AM, Pat Croskerry <croskerry at EASTLINK.CA<mailto:croskerry at EASTLINK.CA>> wrote:

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<mailto:Rana.Samuel at VA.GOV>]
Sent: Friday, January 22, 2016 12:44 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto: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<mailto:Joe.Grubenhoff at CHILDRENSCOLORADO.ORG>]
Sent: Friday, January 22, 2016 11:09 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto: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<mailto: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<mailto:yousefe at CCF.ORG>]
Sent: Friday, January 22, 2016 6:42 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto: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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