Diagnostic error

Diagnostic error is the failure to make and/or communicate a correct and timely explanation of a patient’s health problem to the patient, regardless of whether harm results. Diagnostic error is among the top patient safety concerns but can be difficult to detect and prevent.

Why do diagnostic errors happen?

Factors that can contribute to diagnostic errors include:

System-level factors such as communication breakdowns between providers, erroneous or inadequate diagnostic technology, or inadequate staffing
Cognitive biases such as mental shortcuts that lead health care providers to errors in decision-making
Incomplete or inaccurate patient information such as incomplete medical records or gaps in information-sharing between providers
Limited time with patients that prevents clinicians from obtaining a thorough history, a complete physical examination, or reviewing all relevant medical records
Patient factors, such as a failure or inability to convey relevant medical history or follow up on diagnostic testing

The resources below can be integrated into an organization’s continuous improvement system as tools for diagnostic error identification, analysis, and problem solving.

About diagnostic safety

Diagnostic errors can be reduced with a continuous improvement system that can identify and learn from events, solve underlying problems, and embed improvements.

Learning from errors

Tools to collect key information and identify causes, contributing factors, and opportunities to improve systems to prevent similar events.

View resources

Measuring diagnostic error

Tools that can be immediately applied to support diagnosis-related quality improvement efforts.

VIEW RESOURCES

Case studies

The Primary Care Research in Diagnosis Errors (PRIDE) Learning Network regularly meets to analyze diagnostic error incidents and develop case studies.

View cases

ICDx Center of Excellence

The Betsy Lehman Center is a collaborator in an AHRQ-funded Improving Cancer Diagnosis Center of Excellence.