Friday, July 25, 2014

Searching for stuff: patient safety, DXerror and RCA info. Places to start

I had a colleague ask recently about finding information on root cause analysis in general and in getting started on diving into the diagnostic error evidence base. I recognize that this response is pretty quick and dirty and what I typically don't include on this blog -- but she liked it, so I thought others might as well.
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I wrote ... This safety stuff is very messy to look for—as the language used to study, discuss and (ultimately) search for it varies due to the range of industries that touch it, where the materials reside and that the science of safety is evolving pretty rapidly.

As with any patient safety topic—I always suggest that folks start with AHRQ’s Patient Safety Network:
http://psnet.ahrq.gov/. Not because I help develop it – but it is a good entry way into primary safety topics,  the medical literature (to look for MESH subject headings) and non-pubmed indexed materials.

Check out the primers on both DxError, RCA and failure analysis – all three touch on your question:
http://psnet.ahrq.gov/primer.aspx?primerID=12
http://psnet.ahrq.gov/primer.aspx?primerID=10
http://psnet.ahrq.gov/primer.aspx?primerID=24

Another tidbit if you REALLY want to have a more complete search strategy approach to a patient safety topic -- is to again draw from AHRQ. The released a comprehensive review of patient safety strategies last year: http://www.ahrq.gov/research/findings/evidence-based-reports/ptsafetyuptp.html

There is one on DxError:
http://www.ahrq.gov/research/findings/evidence-based-reports/services/quality/patientsftyupdate/ptsafetyIIchap35.pdf
And what is REALLY helpful (again, if you are aiming to be comprehensive) the authors share the search strategies used to support the reviews in each chapter. See c78 to c80 for the search strategy for the DxError chapter.
http://www.ahrq.gov/research/findings/evidence-based-reports/services/quality/patientsftyupdate/ptsafetyIIapc.pdf

The other thing about DxError is how you client defines it. Delay, over- and under-diagnosis, decision making, cognition, biases (availability and otherwise) etc all could play into a search—depending on what the person is really looking for.

Lastly -- here is an article --  (wish it was free: the first author happens to be a contributor to my new Patient Safety book: https://www.routledge.com/products/9781409438571: )-- that also provides some thinking about search in patient safety: http://qualitysafety.bmj.com/content/19/5/452

Now – this may be more than you want or need – but what I think is useful is the strategies not only give someone like you (and other librarians) a robust place to start, but it illustrates the complexity of searching for materials in the world of patient safety!

Hope it helps.

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