Pathology and laboratory medicine organizations wasted little time before responding to the recent publication by the Institute of Medicine (now a unit of the National Academy of Medicine) on the subject of diagnostic errors.1 The study, Improving Diagnosis in Healthcare, finds that “diagnostic errors—inaccurate or delayed diagnoses—persist throughout all settings of care and continue to harm an unacceptable number of patients,” and offers a series of recommendations for minimizing the risk of errors.
The report’s recommendation that diagnostic professionals should be considered key members of the healthcare team received especially strong support from the laboratory community. “AACC strongly supports initiatives to improve patient care by reducing diagnostic errors and the cost, suffering, and loss of life that stems from these errors,” said David D. Koch, PhD, president of the American Association for Clinical Chemistry. “We fully agree with the National Academies that taking a team approach to the diagnostic process is central to accomplishing this goal, and laboratory medicine professionals will be a key player on any successful team.”
“As key players in the healthcare diagnostic process, it is essential that laboratories recognize their role in this process and engage with all members of the healthcare team with the ultimate goal of improving patient outcomes,” said Douglas Beigel, CEO of lab accreditor COLA. Beigel offered a series of recommendations for how laboratories can help achieve the study’s goals for reducing diagnostic error:
- Collaboration. Laboratorians can embrace teamwork and collaboration among all healthcare professionals by working with clinicians to develop appropriate protocols for not only ordering but also providing interpretation of the test results.
- Training. Increased education and training on laboratory quality should be provided to allied health professionals and all individuals performing any component of laboratory testing, regardless of the complexity of the testing.
- Transparency. Laboratorians and healthcare professionals everywhere should share their stories to encourage a new culture of transparency in reporting of diagnostic and laboratory errors.
- Research. All professionals should urge colleagues in government and the broader healthcare system to further research the relationship between diagnostic and laboratory (particularly waived testing) errors and patient outcomes.
For more about what members of the laboratory community think of the IOM report, see this month’s Inside Track interview (page 34) with Gene N. Herbek, MD, FCAP, president of the College of American Pathologists—and especially the much longer version available online at http://tinyurl.com/otqjork. While many of the report’s recommendations may be difficult to achieve, the willingness of the clinical laboratory community to take on the effort is at least a good starting point.
Chief Editor, CLP
- National Academies of Sciences, Engineering, and Medicine. Improving diagnosis in healthcare. Balogh EP, Miller BT, Ball JR, eds. Washington, DC: The National Academies Press, 2015.