Improving Diagnostic Reasoning to Improve Patient Safety

Successful long‐term maintenance following Nutrition Care Process Terminology implementation across a state‐wide health‐care system

“…It is essential to identify the real nutrition problem in order for the practitioner to follow the NCP and select strategies that will successfully resolve the identified problem. Other professions also recognise the complexity and value of the diagnostic reasoning process . Consequently, it may be anticipated that ongoing education and training support is required to increase confidence during NCPT implementation.…”

Increased familiarity, knowledge and confidence with Nutrition Care Process Terminology following implementation across a statewide health‐care system

“…Correctly identifying the real nutrition problem is essential to successful selection of strategies that will effectively resolve the identified problem. The value and complexity of this diagnostic reasoning process are also recognised by other professions …”

“…The value and complexity of this diagnostic reasoning process are also recognised by other professions. 15,16 Key elements that respondents reported needing to sustain NCPT following the initial implementation included ongoing management support; tutorials and workshops; mentor support; and practice, auditing and discussions. Post implementation, the most valued resources stated for implementing NCPT into practice included pocket guides and 'hint sheets' (with quick reference notes for specific diagnoses), ongoing workshops/tutorials and mentor Post-implementation Pre-implementation Figure 2 Significant changes in attitudes, familiarity, confidence and views concerning NCP and IDNT pre and post implementation across the statewide health-care system (from Table 1).…”

The patient is in: patient involvement strategies for diagnostic error mitigation

“…How are these differences active for patients and providers? What are the implications for applying and adapting current approaches to patient involvement?23 25 Based on evolving input from the diagnostic error community, we have developed an initial list of relatively unique qualities of the diagnostic stage relevant to patient involvement in error prevention: Role of reasoning : those interested in diagnostic error have concentrated on understanding the reasoning process of the diagnostician (eg, Systems 1 and Systems 2 typology of intuitive vs deliberate thinking), and the potential failure points due to cognitive heuristics and biases 26 27. To the extent that patients are involved in diagnosis, they also could be prone to the same biases.…”

“…Role of reasoning : those interested in diagnostic error have concentrated on understanding the reasoning process of the diagnostician (eg, Systems 1 and Systems 2 typology of intuitive vs deliberate thinking), and the potential failure points due to cognitive heuristics and biases 26 27. To the extent that patients are involved in diagnosis, they also could be prone to the same biases.…”