Diagnostic Errors
Conditions
Keywords
Diagnostic Errors, Hospital Medicine
Brief summary
This project will introduce and evaluate an intervention designed to improve diagnostic decision making. The intervention will attempt to increase clinician mindfulness and reduce environmental distractions to promote focused thinking. A meta-cognitive intervention using a structured checklist will be evaluated to identify improvement in diagnostic and therapeutic decision-making and examine the role of mindfulness and architectural design in enhancing patient safety.
Detailed description
This project will introduce and evaluate an intervention designed to improve diagnostic decision making. The intervention will attempt to increase clinician mindfulness and reduce environmental distractions to promote system 2 thinking. A meta-cognitive intervention using a structured checklist will be evaluated to identify improvement in diagnostic and therapeutic decision-making and examine the role of mindfulness and architectural design in enhancing patient safety. This a pretest-posttest design study that will be conducted with hospitalist physicians working at Michigan Medicine and/or the VA Ann Arbor Healthcare System. The proposed intervention will provide the participants with tools to help promote mindfulness and focus to assist with the diagnostic process. To reduce distraction, headphones to block out surrounding noise and table screens to limit distractions will be offered. To assist with diagnosis, a diagnostic checklist and use of a IPad to use an online diagnosis application will be provided.
Interventions
BEHAVIORALMindfulness breathing exercise
Spire monitor instructed mindfulness breathing
BEHAVIORALDiagnostic Checklist
Checklist reminder for diagnosis
BEHAVIORALNoise cancelling headphones
Noise cancelling headphones
BEHAVIORALPrivacy tablescreen
Privacy Tablescreen
BEHAVIORALDiagnostic assistance application
Diagnostic assistance application
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
University of Michigan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Pre-posttest study design
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
Yes
Inclusion criteria
* Hospital Medicine Physicians
Exclusion criteria
* Physicians other than Hopitalists
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Number of Patient Differential Diagnosis | 8 months | Differential Diagnosis |
| Change in the Use of Diagnostic Checklist | 8 months | Diagnostic Checklist |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Time Participants are Measured as Calm | 8 months | Time Measured in Minutes, Using the Spire Monitor |
| Change in Mindfulness Behaviors Score | 8 months | This 4 Question Survey Measures Characteristics of Mindfulness, Range- 1=Always, 6=Never |
| Change in Time Participants are Measured as Tense | 8 months | Time Measured in Minutes, Using the Spire Monitor |
| Change in Time Participants are Measured as Focused | 8 months | Time Measured in Minutes, Using the Spire Monitor |
| Change in Number of Patient Diagnostic Testing | 8 months | Diagnostic Testing includes Laboratory and Imaging |
Countries
United States
Outcome results
None listed