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.