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Diagnosis (Berl). 2014 Jan 1;1(1):55-58. doi: 10.1515/dx-2013-0023.

The diagnostic field's players and interactions: from the inside out.

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1Stanford University School of Medicine and University of California, Berkeley, School of Public Health, Center Health Policy/Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019, USA.


For diagnoses that require inputs from multiple players - patients, informal caregivers, health care professionals - a team approach to coordinating diagnostic care has the potential to improve outcomes. Taking a patient-system perspective helps elucidate important factors relevant to team-based diagnostic performance. These factors are conceptualized as a metaphoric playing field that has goals, players interacting, unavoidable uncertainties and influential social conditions specifically tied to the diagnosis phase of care. In terms of rules of the game, the patient-system interaction might be guided by application of Gittell and colleague's relational coordination concepts, and understood within a broader social network framework of diagnosis, adapted from work by Berkman and colleagues. Patient-centered metrics are also needed to monitor the success of diagnosis.


diagnostic error; patient-centeredness; relational coordination; sociological Influences; teamwork


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