Chris Wilde Profile picture
Aug 31 13 tweets 4 min read
Speed-diagnosing?

@SharonAMcAuley1 presenting on getting to the correct diagnosis quicker #DFTB22
Avoiding the delayed, wrong or missed diagnosis.
#RootCauseAnalysis of diagnostician error
Red team and Blue team

Blue team - see patient, examine, order investigations, etc.
Red team - “devil’s advocate” - ask probing questions, suggest alternative diagnoses

Establishes a culture of a norm of asking and being asked questions #PsychologicalSafety
System I vs System II thinking

Pattern recognition is fast. Then take a diagnostic pause.
Combatting Biases
Be aware of them
Checklists
Check with colleagues
High risk for diagnostic error
Analysis of diagnostic error

Cognitive factors feature highly
Vulnerable groups: indigenous child, CALD child, remote locations, <4yo
Differential diagnosis

Document 4 differential diagnoses in your notes!

SPIT

Serious
Probable
Interesting
Treatable
What will I try to do tomorrow?
What about you?
What are your frames? (HALTS?)
Remember why we do this.
Hopefully this will help reduce diagnostic error.

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More from @cjwilde

Aug 31
The inimitable and inspiring @LizCrowe2 closes #DFTB22 with what matters in the end.
Making meaning

Liz suggests we need to be more political to make meaning of our knowledge
Reflection
Read 14 tweets
Aug 31
@PaedSurg speaking about who is research for? #DFTB22
It starts with one. Like tattoos. Many people have one or two published papers. Few stop at three…

Often start with a case study n=1.
Patient-centred approach to a power analysis.

“How few people can I enrol in this trial so the smallest number of people as possible are exposed to a less efficacious treatment?” #DFTB22
Read 8 tweets
Aug 31
@RosemaryWyber with Ending RHD #DFTB22
New evidence from AoNZ
Good evidence either Strep A throat or skin sores precedes RHD
Actually more complex
*Recurrent infections
*Colonisation
Read 5 tweets
Aug 31
Naomi Spotswood @NaomiSpot presenting on quality improvement #DFTB22
What is quality care?
Quality care doesn’t always happen

Nowhere is perfect

Harm to 1:10 hospitalised patients
$4b cost each year
Read 11 tweets
Aug 31
Bronwyn Griffin @brongriffin presenting on improving burn care #DFTB22
Most burns happen in the home. Most homes also have a tap. Less access in rural and remote locations.

🔑 20 min cool water (within 3 hours)
70% get first aid. Is that enough? What’s an acceptable number?
Read 6 tweets
Aug 31
Jason Acworth @acworthj presenting on rapid response systems. #DFTB22
Reminds us of the 80s when the hair was worn high and so were the pants!
As an intern, emergency response called only when a patient had stopped breathing or lost cardiac output.

1990s the MET call invented in Sydney. Hospital-wide patient-centred system. #DFTB22
Read 12 tweets

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