Doctors should be provided with a “diagnostic cockpit” to reduce the risk of potentially dangerous errors being made during their initial assessment of patients admitted to hospital, a senior consultant has said.
Dr Gordon Caldwell, a consultant physician at Worthing Hospital, Sussex, said he had seen errors made in the working diagnosis that caused harm or even death.
Writing on the British Medical Journal website, Dr Caldwell said errors were sometimes made because doctors were interrupted as they tried to make important decisions in “small hot rooms” or even on corridors where they did not have easy access to laboratory results.
“We must urgently consider how to provide rooms, time and information for doctors to do the most difficult part of their job and the part most prone to error: the clinical thinking in making the working diagnosis and treatment plan.
“Perhaps we need to be like pilots and have a ‘diagnostic cockpit’? Our work is more dangerous than theirs,” he wrote.
Dr Caldwell said medics make a working diagnosis when a sick person is admitted and treat as if that diagnosis is correct. If the patient does not improve, the diagnosis may be reconsidered but Dr Caldwell said a person’s chance of survival may have already been compromised.
“Over my career, I have seen many errors in the working diagnosis causing harm to patients and even death,” he wrote. He said doctors needed the best physical and psychological environments in which to do the “complex clinical thinking” required to make the working diagnosis.
Around a million reports are received each year from NHS trusts on incidents that caused patients harm or could potentially have caused harm.
While the vast majority leave no lasting effect on patients, some cause death or disability.
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