More Collaboration Among Clinicians May Reduce Medical Errors

Working collaboratively leads to more accurate diagnoses and may help reduce medical errors, according to a study published in JAMA.

Working collaboratively leads to more accurate diagnoses and may help reduce medical errors, according to a study published in JAMA.

Since diagnostic errors contribute substantially to preventable medical errors, Wolf E. Hautz, MD, MME, of the Charité Campus Mitte and Campus Virchow Klinikum in Berlin, Germany, and colleagues investigated the effect of working in pairs as opposed to making diagnostic decisions alone.

“Diagnostic decisions usually are not made by individual physicians working alone,” the authors wrote. “Our aim was to investigate the effect of working in pairs as opposed to alone on diagnostic performance.”

The study recruited volunteer fourth-year medical students at Charité Medical School, Berlin, Germany, and had them evaluate 6 simulated cases of respiratory distress. The participants were randomized to work individually or in pairs.

After watching a video presentation of a patient case, the participants had to select the correct diagnostic test or tests from a list of 30. They were instructed to be as fast and accurate as possible.

The authors found that pairs of students more accurately selected the correct diagnosis (68%) compared with individuals (50%). The pairs performed better despite the fact that all the participants had comparable knowledge about the topic and selected an equal number of diagnostic tests.

However, pairs needed more time to reach a diagnosis compared with the individuals. According to the authors, though, the tests that the pairs selected would actually take less time in a real clinical setting. Finally, pairs were more confident with their selected diagnoses than individuals.

"Similar to other studies, collaboration may have helped correct errors, fill knowledge gaps, and counteract reasoning flaws," the authors wrote.

Similarly, a study in the New England Journal of Medicine found that better communication between caregivers also reduces medical errors. Researchers tested a standardized method for medical residents to hand off information about patients at the end of a shift.

“We decreased preventable adverse events by 30 percent, but there was no change in nonpreventable events,” Lauren Destino, MD, a clinical assistant professor of pediatrics at Stanford University and a pediatrician at Lucile Packard Children’s Hospital Stanford, said in a statement. “That suggests that it was the improved handoffs themselves that led to the reduction in errors.”