Despite the importance of learning from patients and families about diagnostic mishaps—their origins, impact, and longer term consequences—to date investment supporting this sort of feedback has been limited. As new initiatives emerge to promote diagnostic safety, it is essential to expand investment and to enhance capacity to rigorously elicit patients’ diagnostic experiences.
The number of extant questions requiring future research might initially seem daunting. But it is important to recognize that many of these questions can remain unanswered while efforts continue to improve diagnostic experiences. Even if it remains unclear how best to feed back patient experience when diagnostic mishaps cross multiple clinical settings, half of the diagnostic problems patients report occur in a single setting. Thus, substantial gains could be achieved by starting with that simpler context.
These challenges are perhaps most pronounced when assessing the persistent impact of perceived diagnostic problems on the subsequent actions and attitudes of patients and their families. Whether or not clinicians or healthcare experts would define diagnostic issues as “errors,” the events patients and families perceived as adverse will nonetheless do damage, undermining the public’s faith in healthcare and medical professionals.
Because we so infrequently elicit information about perceived diagnostic mishaps from the public, the magnitude of these detrimental effects is obscured. But that hidden impact does not diminish its corrosive effect on patient-clinician relationships, confidence in healthcare facilities, and trust in healthcare generally.54,55 We need to better understand these broad effects in order to respond to them in a more systematic and effective manner.
To pursue this goal, we must aspire to more effectively learn from patient experiences. One crucial prerequisite for this effort is creating the capacity to track patient experience in the aftermath of diagnostic problems across multiple subsequent treatment settings. This step is essential toward building a collective understanding of the long-persisting impact of diagnostic breakdowns. That, in turn, seems an essential first step in mustering the collective wherewithal to more effectively assist patients and families in the aftermath of these diagnostic mishaps.
We have the methods to learn more about the impact of diagnostic errors on patients and families. We must now commit to the actions that can deploy these methods to best promote learning and, in the longer run, improve diagnostic safety.
