Joint Commission warns of 'diagnostic overshadowing' in new sentinel event alert

The Joint Commission on June 22 issued a sentinel event alert to turn more attention to the effects of diagnostic overshadowing — the attribution of symptoms to an existing diagnosis instead of a possible comorbid condition — and actions to address it. 

"Diagnostic overshadowing is a serious safety and quality concern as an initial misdiagnosis can have a significant impact on quality of life, including the physical and psychological wellness of patients," said Ana Pujols McKee, MD, executive vice president, chief medical officer, and chief diversity, equity and inclusion officer at The Joint Commission. "I urge my physician colleagues to recognize that diagnostic overshadowing stems from cognitive bias and work to reduce this through training and education programs." 

The quality improvement and patient safety group said diagnostic overshadowing exists among interactions between clinicians and patients with physical disabilities or previous diagnoses, and others experiencing health disparities. The sentinel alert outlines action items to address the issue, such as listening and interview techniques designed to enhance patient engagement and shared decision-making. 

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