Recognizing Bias, Reducing Error: A Case-Based Study for Improvement in the Emergency Department

Since the Institute of Medicine's initial report on medical error was published in 1999, understanding of the magnitude of this problem within health care continues to grow. Although medical error is a broad category that includes both system and human factors, diagnostic error, with significant consequences for patients and their families, bias is a common and often overlooked contributor. This type of error is complex, as it is rooted in clinicians' use of heuristics and their inherent or cognitive biases. The objective of this review is to define medical error and to explore the methods that can be used to reduce error in clinical practice. Using a case-based discussion, cognitive bias resulting in diagnostic error will be reviewed.