The Cognitive Autopsy: A Root Cause Analysis of Medical Decision Making 1st Edition Pat Croskerry

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Product details:

• ISBN-10 ‏ : ‎ 0190088745
• ISBN-13 ‏ : ‎ 978-0190088743
• Author: Pat Croskerry

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.

Table of contents:

Case 1. Christmas Surprises

Case 2. Distraught Distraction

Case 3. The Fortunate Footballer

Case 4. An Incommoded Interior Designer

Case 5. Teenage Tachypnea

Case 6. The Backed-Up Bed Blocker

Case 7. The English Patient

Case 8. Lazarus Redux

Case 9. A Model Pilot

Case 10. A Rash Diagnosis

Case 11. The Perfect Storm

Case 12. A Case of Premature Closure

Case 13. Postpartum Puzzler

Case 14. The Blind Leading the Blindable

Case 15. Pseudodiagnosis of Pseudoseizure

Case 16. Failed Frequent Flyers

Case 17. Explosions, Expletives, and Erroneous Explanations

Case 18. The Representativeness Representative

Case 19. The Michelin Lady

Case 20. An Instable Inadvertence

Case 21. A Laconic Lad

Case 22. The Misunderstood Matelot

Case 23. A Hard Tale to Swallow

Case 24. A Rake’s Progress

Case 25. Deceptive Detachment

Case 26. A Search Satisfied Skateboarder

Case 27. The Vacillated Vagrant

Case 28. A Tale of Two Cycles

Case 29. Misleading Mydriasis

Case 30. Bungled Bullae

Case 31. Overdosing the Overdosed

Case 32. The Lost Guide

Case 33. Hazardous Handover

Case 34. Double Trouble

Case 35. Tracking Fast and Slow

Case 36. Alternate Alternatives

Case 37. Notable Near Miss

Case 38. A Stone Left Unturned

Case 39. Sweet Nothings

Case 40. Straining the Strain Diagnosis

Case 41. Missed It

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