SHM Converge Scientific Abstract ePoster Gallery-Understanding Everyday Safety: An Ethnographic Study of Hospitalist Diagnostic Work

Pdf Summary

This ethnographic study examined how hospitalists make diagnoses in everyday inpatient practice, focusing on the personal, team, and system-level factors that shape diagnostic work. Embedded in the ADEPT study, researchers observed clinicians during clinical shifts and conducted semi-structured interviews and focus groups afterward with clinicians on general medicine teaching and non-teaching services.<br /><br />The study highlights that diagnosis is not just a cognitive task; it is a dynamic process influenced by workload, census, testing availability, interpreter access, time constraints, and other operational barriers. Hospitalists often rely on adaptive strategies and collaboration to manage uncertainty and avoid diagnostic errors.<br /><br />The findings suggest that improving diagnostic safety requires more than individual clinician skill. Building a culture of diagnostic excellence should emphasize collective intelligence and collaborative practice. This could include formalizing support from peer clinicians, interprofessional team members, patients, and caregivers.<br /><br />The authors conclude that interventions should strengthen hospitalists’ ability to navigate uncertainty and system barriers, while also reducing clinical constraints within the healthcare system. Doing so may improve diagnostic accuracy and support safer, more effective inpatient care.

Asset Subtitle

Angela Keniston

Meta Tag

Author List Abigail Peterson, Andrew D. Auerbach, Andrew P.J Olson, Angela Keniston, Ellen Barbouche, Jason John, Jeffrey L. Schnipper, Katie E. Raffel, Michelle Knees, Rachel. L J. Weiss, Sandhya Tagaram, Scott Saunders

Category Research

Concept Diagnostic Process

Concept Diagnostic Error

Concept Diagnostic Safety

Concept Diagnosis

Concept Physician-Nurse Teamwork

Distinguished Non-Finalist

Presenter Organization University of Colorado School of Medicine

Presenting Author Angela Keniston

Track Patient Safety

Keywords

hospitalist diagnosis

diagnostic safety

inpatient care

ethnographic study

clinical uncertainty

team collaboration

healthcare systems

diagnostic excellence

operational barriers

adaptive strategies

Diagnostic Process

Diagnostic Error

Diagnostic Safety

Diagnosis

Physician-Nurse Teamwork