走向更安全的诊断:基于SEIPS的诊断错误叙述审查
Carol Yen1,2, John W Epling3, Michelle Rockwell4
1Department of Health Systems and Implementation Science, Virginia Tech School of Medicine, Roanoke, VA 24014, USA.
Diagnostics (Basel, Switzerland)
|January 28, 2026
概括
诊断错误威胁到患者的安全,增加医疗保健成本. 本综述强调了相互关联的系统因素,包括社会行为因素,有助于诊断错误.
科学领域:
- 医疗保健系统分析 医疗保健系统分析
- 患者安全研究 患者安全研究
- 医学诊断 医学诊断 医学诊断
背景情况:
- 诊断错误是医疗保健中的一个重大问题,它影响了患者的安全,并造成了大量的财务成本.
- 美国国家科学,工程和医学院 (NASEM) 在诊断疾病时强调准确性,及时性和沟通性.
- 基于系统的方法对于理解诊断错误的多面性质至关重要.
研究的目的:
- 从系统的角度来看,整合有关诊断错误的现有文献.
- 检查影响诊断准确性和及时性的各个领域的贡献因素.
- 提供诊断错误原因及其相互联系的全面概述.
主要方法:
- 进行了叙事文学评论.
- 患者安全系统工程倡议 (SEIPS) 模型提供了框架,重点关注六个关键领域.
- 分析和合成了在这些领域内识别导致诊断错误的因素的研究.
主要成果:
- 诊断的有效性受到所有六个SEIPS领域的复杂,相互关联的因素的影响.
- 社会行为因素 (团队沟通,认知偏见,工作负担) 和环境压力是重要的贡献者.
- 像电子健康记录 (EHR) 这样的传统数据源往往无法捕捉到这些关键的社会行为元素.
结论:
- 诊断错误源于医疗保健系统内部复杂的相互作用,超越技术方面.
- 未来的研究必须解决技术和行为因素,以减轻诊断错误.
- 基于系统的整体方法对于提高诊断准确性和患者的治疗结果至关重要.
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