The ED is a complex, chaotic environment unlike any other in healthcare. Clinicians who work there must make diagnoses under trying circumstances while patients who seek care give up their autonomy and control in an effort to get relief for whatever ails them. Thus, it is no wonder that diagnostic errors occur.
Addressing the problem of diagnostic error by understanding and optimizing the diagnostic process in this unique setting is a challenge. The theory of distributed cognition recognizes the collective, social nature of cognition in context and provides a particularly appropriate and useful framework, suggesting how nurses can promote diagnostic quality. Emphasizing the role of nurses in diagnostic safety through the lens of distributed cognition would be a major advance in the quest to limit harm associated with these errors.
