What is it about?
To break the cycle of diagnostic waste we introduce physicians to the concept of workflow diagrams or value streams. And show how the diagrams or maps help them to conceptualize management of patients when the diagnosis is uncertain. By applying an iterative workflow map and utilizing a critical formula for choosing high value diagnostic tests (Bayes' theorem) clinicians can save time, reduce processing complexity, and increase their diagnostic accuracy.
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Why is it important?
Diagnostic waste and diagnostic error are major challenges in modern healthcare. Approximately 1/4 of patients suffer harm because to diagnostic delay or diagnostic error. It has been estimated that 1/3 of everything we do in healthcare is unnecessary and therefore represent waste. This approach promises to reduce diagnostic error and reduce wasteful testing.
Perspectives
As an infectious disease specialist I have been frustrated by my fellow clinicians ordering of excess numbers of tests and have also been concerned by their shotgun approach to diagnostic ordering. They order everything they can think of and then wait and see which tests are positive to decide on the diagnosis. Unfortunately this approach is costly, time consuming and leads to misdiagnosis.
Frederick Southwick
University of Florida College of Medicine
Read the Original
This page is a summary of: Teaching novice clinicians how to reduce diagnostic waste and errors by applying the Toyota Production System, Diagnosis, March 2019, De Gruyter,
DOI: 10.1515/dx-2018-0081.
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