Evidence map›Paper›PMID 31605828›Full record

ArticleApplied ergonomics2020

Reducing delays to diagnosis in ambulatory care settings: A macrocognition perspective.

Emily S Patterson, George Su, Urmimala Sarkar

Abstract read
In one paragraph

Article in Applied ergonomics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Human Factors and Organizational Issues.Yearbook of medical informatics · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Emily S PattersonThe Ohio State University, Division of Health Information Management and Systems, School of Health and Rehabilitation Sciences, College of Medicine, USA. Electronic address: patterson.150@osu.edu.
George SuUniversity of California San Francisco, Division of General Internal Medicine, UCSF Center for Vulnerable Populations, USA.
Urmimala SarkarUniversity of California San Francisco, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, USA.

Funding

AHRQ HHS P30 HS023558
6 · The paper itself

Abstract

We aim to use a macrocognition theoretical perspective to characterize contributors to diagnostic delays by physicians that can be mitigated by work system redesign. As experienced with other complex, sociotechnical domains, system redesign is anticipated to be more effective at improving safety than training-based solutions. In the outpatient care setting, complex tasks, conducted by a primary care provider, are provided for five macrocognition functions: sensemaking, re-planning, detecting problems, deciding, and coordinating. Redesigning systems could reduce delays to diagnosis by helping users to avoid missed symptoms, forgotten follow-up activities, and delayed actions. Health information technology could support resilience strategies by offloading documentation burdens, recording working diagnoses, displaying planned follow-up activities at the correct time interval, and supporting recognition of patterns in patient care. These insights suggest a path forward for future research on system design innovations to reduce diagnostic delays, and ultimately, reduce patient harm.

Indexed as

Ambulatory CareCognitionDelayed DiagnosisHarm ReductionHumansModels, TheoreticalPhysiciansQuality of Health CareAmbulatory careDelayed diagnosisHuman factorsMedical informaticsPatient harm

Identifiers

PMID31605828
PMCPMC7757423

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.