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Books > Social sciences > Psychology > Cognition & cognitive psychology
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The Cognitive Autopsy - A Root Cause Analysis of Medical Decision Making (Paperback)
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The Cognitive Autopsy - A Root Cause Analysis of Medical Decision Making (Paperback)
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Behind heart disease and cancer, medical error is now listed as one
of the leading causes of death. Of the many medical errors that may
lead to injury and death, diagnostic failure is regarded as the
most significant. Generally, the majority of diagnostic failures
are attributed to the clinicians directly involved with the
patient, and to a lesser extent, the system in which they work. In
turn, the majority of errors made by clinicians are due to decision
making failures manifested by various departures from rationality.
Of all the medical environments in which patients are seen and
diagnosed, the emergency department is the most challenging. It has
been described as a "wicked" environment where illness and disease
may range from minor ailments and complaints to severe,
life-threatening disorders. The Cognitive Autopsy is a novel
strategy towards understanding medical error and diagnostic failure
in 42 clinical cases with which the author was directly involved or
became aware of at the time. Essentially, it describes a cognitive
approach towards root cause analysis of medical adverse events or
near misses. Whereas root cause analysis typically focuses on the
observable and measurable aspects of adverse events, the cognitive
autopsy attempts to identify covert cognitive processes that may
have contributed to outcomes. In this clinical setting, no
cognitive process is directly observable but must be inferred from
the behavior of the individual clinician. The book illustrates
unequivocally that chief among these cognitive processes are
cognitive biases and other flaws in decision making, rather than
knowledge deficits.
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