Nurses - Key Members of the Diagnostic Team

Mark Graber Mark.Graber at IMPROVEDIAGNOSIS.ORG
Sat Dec 2 22:10:58 UTC 2017


At this year’s Diagnostic Error in Medicine conference, one of the outstanding sessions, Engaging Nursing in Diagnostic Error, was led by Kelly Gleason<mailto:kgleaso2 at jhmi.edu> and Kathleen Rea.  I am delighted to announce as an outgrowth from this session a new nursing-focused community of practice associated with SIDM, which Kelly has agreed to lead going forward.

The #1 recommendation in the landmark report, Improving Diagnosis in Health Care<https://www.nap.edu/catalog/21794/improving-diagnosis-in-health-care>, is to facilitate and support teamwork in the diagnostic process.  This concept was the central theme of this year’s 10th annual Diagnostic Error in Medicine conference: “Improving Diagnosis – It Takes a Team”.  Amy Edmondson’s talk, The End of the Team as We Know It, was a conference highlight that introduced this new vision, and the role that nurses can and should play as partners in the diagnostic process.  In this new framework, the nurse provides key observations on the patient and input on the diagnostic possibilities, monitors whether communication was effective, contributes to care coordination, and observes whether the patient’s course is consistent or not with the diagnoses being considered.

Several very recent publications in the SIDM newsletter and our journal DIAGNOSIS<mailto:https://www.degruyter.com/view/j/dx> explore the new teamwork concept, and the role of nurses:

Gleason et al:              Defining the critical role of nurses in diagnostic error prevention<https://www.degruyter.com/view/j/dx.2017.4.issue-4/dx-2017-0015/dx-2017-0015.xml?utm_source=Copy+of+Campaign+Created+2017%2F08%2F30%2C+2%3A47+PM&utm_campaign=DIAGNOSIS&utm_medium=email>: a conceptual framework and a call to action
Graber et al:                The New Diagnostic Team<https://www.degruyter.com/view/j/dx.2017.4.issue-4/dx-2017-0022/dx-2017-0022.xml?utm_source=Copy+of+Campaign+Created+2017%2F08%2F30%2C+2%3A47+PM&utm_campaign=DIAGNOSIS&utm_medium=email>
Julie Considine:            Nurses, Diagnosis, and Diagnostic Error<https://www.degruyter.com/view/j/dx.2017.4.issue-4/dx-2017-0027/dx-2017-0027.xml?utm_source=Copy+of+Campaign+Created+2017%2F08%2F30%2C+2%3A47+PM&utm_campaign=DIAGNOSIS&utm_medium=email>
Susan Carr:                   The Evolution of Diagnostic Teamwork<http://c.ymcdn.com/sites/www.improvediagnosis.org/resource/resmgr/ImproveDx_Oct2017final.pdf>

A relevant project being pursued by the SIDM Education Committee is work funded by the Josiah Macy Jr Foundation:  Developing an Interprofessional Curriculum to Improve Diagnosis.  This is a 3 year project to identify the curriculum all trainees in healthcare, including nurses, should receive to improve diagnostic quality and safety.

We look forward to more effective nurse engagement as one of the most promising interventions available to improve the quality and safety of diagnosis.


Mark L Graber, MD FACP
President, SIDM
Senior Fellow, RTI International
Professor Emeritus, Stony Brook University, NY
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