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Systems Errors

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Cognitive Errors and Diagnostic Mistakes

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Abstract

This chapter discusses several aspects of clinical care that are not intrinsic cognitive biases, but rather features of modern medicine that profoundly affect clinicians’ decision-making processes, at times forcing them to provide suboptimal care to their patients. These are:

  • Alarm Fatigue : Alarm fatigue occurs when clinicians become immune to warnings about their patients due to repeated false alarms.

  • Defensive Medicine : Defensive medicine occurs when care is driven not by what is in the best interest of the patient, but rather what is likely to protect the clinician from a malpractice suit.

  • Graded Clinician Error : The graded clinician error occurs when clinicians who are graded on their patients’ outcome respond to this incentive by refusing to treat the sickest patients or by exaggerating their problems to make them appear more ill than they really are.

  • Electronic Medical Record Error: The electronic medical record error occurs when clinicians are forced to slavishly click buttons on computer to give the appearance of taking care of their patients at the expense of actually taking care of their patients.

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  1. Neurology and Psychiatry, NYU Langone Medical Center, New York, NY, USA

    Jonathan Howard MD

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Howard, J. (2019). Systems Errors. In: Cognitive Errors and Diagnostic Mistakes. Springer, Cham. https://doi.org/10.1007/978-3-319-93224-8_28

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  • DOI: https://doi.org/10.1007/978-3-319-93224-8_28

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