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Diagnostic Error: A Multidisciplinary Exploration

There are no sessions currently scheduled for this class, the following information may be out of date

Class Description | Agenda

8:30AM-4PM (30 min lunch break)

Class Description

A free, interactive workshop for medical decision makers and information professionals, focusing on how multidisciplinary teams can contribute to the reduction of diagnostic error, which is a major factor in patient harm and also increases medical costs. This innovative session will highlight evidence-based processes and the collaborative roles of clinicians and librarians/informationists, as they work together to reduce factors contributing to diagnostic error.

In order to gain maximum benefit from the class, the instructors strongly encourage librarians to attend the session with a clinical partner, e.g., MD, nurse, patient safety officer, etc.

Presenters: Mark Graber, Barbara Jones and Lorri Zipperer

CE is offered for this class.

Objectives and Session Outline

Attendees will be able to:
  • Understand primary concepts related to Diagnostic error (DxError) in medicine
  • Use case analysis to examine the role of information and evidence in the diagnostic process
  • Consider bias as a factor in DxError and how Information/Evidence can address that
  • Apply Root Cause Analysis techniques to identify failure and opportunity at the case level
  • Explore EI&K process improvement and strategic opportunities for librarians.


Registration and Networking (8:30–9:00AM)

Introductions & Welcome (9:00–9:15AM)

  • Who we are and why we are here
  • Session objectives

Part 1: Set the stage for improvement (9:15-11:00AM)

This section will provide attendees with a system-safety perspective from which to place session content. It will define the nuts and bolts of the problem of diagnostic error

  • Core considerations and context /
  • Dx Error – an introduction /
  • Deeper understanding of influential factors/
    • “Flesh and blood decision making”
    • Bias
    • Human Factors
    • Information and Evidence as factors
    • Small group work

Break (15 minutes)

Part 2: Introduction to Failure Analysis (11:15AM-Noon)

This section introduces failure analysis processes and highlights Root Cause Analysis as the structure for the workshop

  • General intro to failure analysis /
  • Root Cause – concept introductions /
    • Small group work

Lunch Break and Video (30 minutes)

Part 3: Getting to the root of the problem // Info and Evidence (12:45–2:30pm)

  • Key Tools Discussion /
    • DxError Case discussion
    • Analysis of problems through RCA

Break (15 minutes)

Part 4: Find Experts and Partners (2:45–3:45PM)

Identifying Targets, goals and strategies to develop opportunities to collaborate on team approach working toward improvement

  • Building on Success / knowledge – what can librarians bring to the table
  • Using RCA findings to design system-level improvements
  • Develop opportunities /
    • Small group work
  • Challenge /what will you do now /
Close and Evaluation.

There are no available sessions of this class