Diagnostic errors are an important quality and safety issue in health care. In an earlier installment of Annals for Hospitalists, Zwaan and Singh explained how diagnostic errors arise from a combination of systems and cognitive factors (1). Systems improvements often take years to unfold, but cognitive improvement can begin today. How can motivated clinicians begin to improve their diagnostic performance?

Every model of performance improvement is built on the foundation of feedback. But when it comes to diagnostic performance, hospitalists scarcely get it. There is feedback on billing. There is feedback on length of stay. There is feedback on medication reconciliation rates. But there are no systems to deliver feedback on the most important metric of all: a correct diagnosis.

中文翻译：

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住院医生年鉴住院笔记-卓越的诊断始于不间断的观察

诊断错误是医疗保健中重要的质量和安全问题。Zwaan和Singh在较早的《医院病历》一书中，解释了系统和认知因素共同导致的诊断错误（1）。系统的改进通常需要花费数年的时间才能显现出来，但是认知的改进可以从今天开始。积极进取的临床医生如何开始改善其诊断性能？

每种绩效改进模型都建立在反馈的基础上。但是，就诊断性能而言，医院医生几乎无法获得。有关于计费的反馈。有关于停留时间的反馈。有关药物对帐率的反馈。但是，没有任何系统可以提供有关所有最重要指标的反馈：正确的诊断。