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A Program to Provide Clinicians with Feedback on Their Diagnostic Performance in a Learning Health System
Joint Commission Journal on Quality and Patient Safety
|September 27, 2020
Summary
Clinicians can learn from diagnostic feedback without discomfort. A new program at Geisinger successfully provided constructive feedback on missed diagnostic opportunities, improving future diagnostic safety.
Area of Science:
- Healthcare Quality Improvement
- Medical Education
- Patient Safety
Background:
- Diagnostic errors are a significant concern in healthcare.
- Clinicians often experience discomfort when receiving feedback on diagnostic performance.
- Improving diagnostic excellence requires effective feedback mechanisms.
Purpose of the Study:
- To develop and implement a diagnostic performance feedback program.
- To mitigate clinician discomfort associated with receiving feedback.
- To foster a learning health system focused on diagnostic safety.
Main Methods:
- Identified missed opportunities in diagnosis (MODs) from multiple sources.
- Confirmed MODs through chart reviews.
- Utilized trained facilitators to deliver feedback on MODs as learning opportunities.
Main Results:
- 90.6% of facilitators reported recipients were receptive to feedback.
- 83.3% of recipients found feedback constructive and nonpunitive.
- 76.7% of recipients reported taking concrete steps to improve diagnosis.
Conclusions:
- An institutional program for diagnostic performance feedback was successfully developed and implemented.
- This program has the potential to facilitate learning and reduce missed diagnostic opportunities.
- Future research should evaluate the long-term impact on diagnostic performance and patient outcomes.
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