Understanding Bias Helps Improve Patient Safety


Tuesday, January 30
1:00 p.m. – 5:30 p.m.
Rooms 301-302

Medical errors may have roots in cognitive biases

In this era of evidence-based medicine, evidence can sometimes be ignored during diagnosis and treatment, leading to adverse events. The 2018 Patient Safety Symposium will explore how cognitive biases and “rules of thumb” can affect clinical decisions.

“The purpose of the symposium is to explore, understand, and talk about these biases,” said moderator Michael S. Kent, MD. “We will give specific examples to help explain these biases and how we make decisions when it comes to individual patients.”

Symposium topics include how heuristics affect everyday decisions, why evidence is sometimes ignored, how root cause analysis could be used to reduce biases, and how surgeons can learn from errors.

Physicians often must make decisions when the evidence does not appear to fit a specific case or if no guidelines have been developed, said Dr. Kent, a member of the STS Workforce on Patient Safety.

“Even though there is a lot of evidence for helping us make clinical decisions, it is our job as physicians to make individual decisions based on individual patients,” he said. “With that context, there are a lot of biases that come into play when we make decisions.”

One speaker will be a psychiatrist with an expertise in understanding biases. He will explain heuristics, which are rules of thumb used in everyday life.

“We allow these biases to become part of our subconscious, and they make a great impact on how we make decisions,” Dr. Kent said. “The psychiatrist will explain how they are present even if we don’t know about them and how they affect our decision making.”

A cardiothoracic surgeon will explore why surgeons override guidelines, such as those for blood transfusion rates. There is great variability among institutions and even among surgeons in the same institution about transfusion rates, Dr. Kent said.

Biases are at the root of this variability, and one option to reduce their impact is root cause analysis.

“This is a technique where providers look at a surgical error in retrospect and try to understand why it happened,” Dr. Kent said. “The goal is to prevent future errors. Root cause analysis has been useful in helping providers identify biases that might impact their decisions.”

In addition, a cognitive psychologist, whose focus has been the integration of concepts from psychology, computer science, and the social sciences, will address how experts in medicine and other high-pressure environments make decisions and deal with complexity.

The symposium will conclude with a panel discussion and a question-and-answer session.