Tags

Type your tag names separated by a space and hit enter

Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report on Diagnostic Error.
Radiology. 2017 04; 283(1):231-241.R

Abstract

In September 2015, the Institute of Medicine (IOM) published a report titled "Improving Diagnosis in Health Care," in which it was recommended that "health care organizations should adopt policies and practices that promote a nonpunitive culture that values open discussion and feedback on diagnostic performance." It may seem counterintuitive that a report addressing a highly technical skill such as medical diagnosis would be focused on organizational culture. The wisdom becomes clearer, however, when examined in the light of recent advances in the understanding of human error and individual and organizational performance. The current dominant model for radiologist performance improvement is scoring-based peer review, which reflects a traditional quality assurance approach, derived from manufacturing in the mid-1900s. Far from achieving the goals of the IOM, which are celebrating success, recognizing mistakes as an opportunity to learn, and fostering openness and trust, we have found that scoring-based peer review tends to drive radiologists inward, against each other, and against practice leaders. Modern approaches to quality improvement focus on using and enhancing interpersonal professional relationships to achieve and maintain high levels of individual and organizational performance. In this article, the authors review the recommendations set forth by the recent IOM report, discuss the science and theory that underlie several of those recommendations, and assess how well they fit with the current dominant approach to radiology peer review. The authors also offer an alternative approach to peer review: peer feedback, learning, and improvement (or more succinctly, "peer learning"), which they believe is better aligned with the principles promoted by the IOM. © RSNA, 2016.

Authors+Show Affiliations

From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105 (D.B.L.); Texas Children's Hospital, Houston, Tex (L.F.D.); Nemours Children's Health System, Orlando, Fla (D.J.P.); Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); Kaiser Permanente, Denver, Colo (R.E.S.); and Beth Israel Deaconess Medical Center, Boston, Mass (J.B.K.).From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105 (D.B.L.); Texas Children's Hospital, Houston, Tex (L.F.D.); Nemours Children's Health System, Orlando, Fla (D.J.P.); Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); Kaiser Permanente, Denver, Colo (R.E.S.); and Beth Israel Deaconess Medical Center, Boston, Mass (J.B.K.).From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105 (D.B.L.); Texas Children's Hospital, Houston, Tex (L.F.D.); Nemours Children's Health System, Orlando, Fla (D.J.P.); Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); Kaiser Permanente, Denver, Colo (R.E.S.); and Beth Israel Deaconess Medical Center, Boston, Mass (J.B.K.).From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105 (D.B.L.); Texas Children's Hospital, Houston, Tex (L.F.D.); Nemours Children's Health System, Orlando, Fla (D.J.P.); Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); Kaiser Permanente, Denver, Colo (R.E.S.); and Beth Israel Deaconess Medical Center, Boston, Mass (J.B.K.).From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105 (D.B.L.); Texas Children's Hospital, Houston, Tex (L.F.D.); Nemours Children's Health System, Orlando, Fla (D.J.P.); Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); Kaiser Permanente, Denver, Colo (R.E.S.); and Beth Israel Deaconess Medical Center, Boston, Mass (J.B.K.).From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105 (D.B.L.); Texas Children's Hospital, Houston, Tex (L.F.D.); Nemours Children's Health System, Orlando, Fla (D.J.P.); Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); Kaiser Permanente, Denver, Colo (R.E.S.); and Beth Israel Deaconess Medical Center, Boston, Mass (J.B.K.).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27673509

Citation

Larson, David B., et al. "Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report On Diagnostic Error." Radiology, vol. 283, no. 1, 2017, pp. 231-241.
Larson DB, Donnelly LF, Podberesky DJ, et al. Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report on Diagnostic Error. Radiology. 2017;283(1):231-241.
Larson, D. B., Donnelly, L. F., Podberesky, D. J., Merrow, A. C., Sharpe, R. E., & Kruskal, J. B. (2017). Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report on Diagnostic Error. Radiology, 283(1), 231-241. https://doi.org/10.1148/radiol.2016161254
Larson DB, et al. Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report On Diagnostic Error. Radiology. 2017;283(1):231-241. PubMed PMID: 27673509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report on Diagnostic Error. AU - Larson,David B, AU - Donnelly,Lane F, AU - Podberesky,Daniel J, AU - Merrow,Arnold C, AU - Sharpe,Richard E,Jr AU - Kruskal,Jonathan B, Y1 - 2016/09/27/ PY - 2016/9/28/pubmed PY - 2017/6/1/medline PY - 2016/9/28/entrez SP - 231 EP - 241 JF - Radiology JO - Radiology VL - 283 IS - 1 N2 - In September 2015, the Institute of Medicine (IOM) published a report titled "Improving Diagnosis in Health Care," in which it was recommended that "health care organizations should adopt policies and practices that promote a nonpunitive culture that values open discussion and feedback on diagnostic performance." It may seem counterintuitive that a report addressing a highly technical skill such as medical diagnosis would be focused on organizational culture. The wisdom becomes clearer, however, when examined in the light of recent advances in the understanding of human error and individual and organizational performance. The current dominant model for radiologist performance improvement is scoring-based peer review, which reflects a traditional quality assurance approach, derived from manufacturing in the mid-1900s. Far from achieving the goals of the IOM, which are celebrating success, recognizing mistakes as an opportunity to learn, and fostering openness and trust, we have found that scoring-based peer review tends to drive radiologists inward, against each other, and against practice leaders. Modern approaches to quality improvement focus on using and enhancing interpersonal professional relationships to achieve and maintain high levels of individual and organizational performance. In this article, the authors review the recommendations set forth by the recent IOM report, discuss the science and theory that underlie several of those recommendations, and assess how well they fit with the current dominant approach to radiology peer review. The authors also offer an alternative approach to peer review: peer feedback, learning, and improvement (or more succinctly, "peer learning"), which they believe is better aligned with the principles promoted by the IOM. © RSNA, 2016. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/27673509/Peer_Feedback_Learning_and_Improvement:_Answering_the_Call_of_the_Institute_of_Medicine_Report_on_Diagnostic_Error_ L2 - https://pubs.rsna.org/doi/10.1148/radiol.2016161254?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -