Diagnostic decision-making is a highly complex cognitive process involving uncertainty, which makes it susceptible to errors. Clinicians working in emergency departments (EDs) are particularly vulnerable to making diagnostic errors because of time-pressured decision-making in chaotic environments. There are ~ 141 million annual ED visits in the US. A conservative estimate of a 5% diagnostic errors in adults translates into ~ 7million cases of diagnostic errors in the ED, with nearly half with potential for patient harm. Diagnostic errors result from a complex interplay between various patient (health literacy, presenting complaint, complexity, etc.), provider/care-team (cognitive load on providers, information gathering/synthesis, etc.) and systems (health information technology, crowding, interruptions, etc.) factors. To reduce diagnostic errors in the ED, we must use methods that illustrate the dynamics of human-system interaction during diagnostic process.

Our goal is to create "Improving Diagnosis in Emergency and Acute care - Learning Laboratory" (IDEA-LL), a novel program for diagnostic safety surveillance and intervention using actionable, patient-centered data obtained from both frontlines of care and electronic health records (EHRs). IDEA-LL will use multidisciplinary approaches to design, implement and evaluate interventions to improve diagnostic safety. The investigative team, led by a unique physician-engineer partnership, will form a transdisciplinary environment of clinicians, nurses, patients, engineers, informaticians and designers as an integral aspect of the learning laboratory to address both pediatric and adult emergency care in academic and community EDs.

Principal Investigator: Prashant Mahajan, MD, MPH, MBA

Co-investigators: Sun Young Park, Hardeep Singh, Kalyan Pasupathy