Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T05:27:04.677Z Has data issue: false hasContentIssue false
  • English
  • Français

BEHAVIOURAL DESIGN FOR MEDICAL ERRORS DURING PATIENT DIAGNOSIS PROCESS

Published online by Cambridge University Press:  19 June 2023

Swagatam Dey ,
Shweta Dabral  and
Pramod Khadilkar
Swagatam Dey*
Affiliation:
Indian Institute of Technology, Delhi
Shweta Dabral
Affiliation:
Indian Institute of Technology, Delhi
Pramod Khadilkar
Affiliation:
Indian Institute of Technology, Delhi
*
Dey, Swagatam, Indian Institute of Technology, India, swagatam.dey@design.iitd.ac.in

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The health and well-being sector has been of significant interest to the behavioural design domain since bringing in behavioural changes can help improve the overall well-being of a community. However, the domain's intervention in this sector has been limited to persuasive techniques for the adoption of healthier lifestyles. There is a need to consider the diagnostic actions and decisions undertaken by doctors as it represents an important part of health and well-being improvement of people. Medical errors committed by healthcare professionals are an important aspect of the healthcare domain. Since these errors result due to undesired or non-normative behaviours, behavioural design can be instrumental in their eradication. But the research on integrating behavioural design and medical error literature is still nascent.

In this paper, we address this gap by identifying the categories of errors based on the performance levels within which they occur. Next, we contextualise these errors categories to medical literature focusing on the diagnostic stage. We further link it to the behavioural change model of COM-B to determine preliminary intervention functions that can be utilised by behavioural designers to deploy interventions.

Keywords

Medical ErrorsBehavioural DesignDecision makingDesign methodsSocial responsibility
Type
Article
Information
Proceedings of the Design Society , Volume 3: ICED23 , July 2023 , pp. 767 - 776
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
The Author(s), 2023. Published by Cambridge University Press

References

Bay Brix Nielsen, C.K.E., Daalhuizen, J. and Cash, P.J. (2021), “Defining the behavioural design space”, International Journal of Design, Vol. 15 No. 1, pp. 1–16.Google Scholar
Blumenthal-Barby, J.S. and Krieger, H. (2015), “Cognitive biases and heuristics in medical decision making: A critical review using a systematic search strategy”, Medical Decision Making, Vol. 35 No. 4, pp. 539–557. http://doi.org/10.1177/0272989X14547740.CrossRefGoogle ScholarPubMed
Bornstein, B.H. and Emler, A.C. (2001), “Rationality in medical decision making: A review of the literature on doctors’ decision-making biases”, Journal of Evaluation in Clinical Practice, Vol. 7 No. 2, pp. 97–107. http://doi.org/10.1046/j.1365-2753.2001.00284.x.CrossRefGoogle ScholarPubMed
Cowdell, F. and Dyson, J. (2019), “How is the theoretical domains framework applied to developing health behaviour interventions? A systematic search and narrative synthesis”, BMC Public Health, Vol. 19 No. 1, pp. 1–10. http://doi.org/10.1186/s12889-019-7442-5.CrossRefGoogle Scholar
Croskerry, P. (2009a), “Clinical cognition and diagnostic error: Applications of a dual process model of reasoning”, Advances in Health Sciences Education, Vol. 14 No. 1, pp. 27–35. http://doi.org/10.1007/s10459-009-9182-2.CrossRefGoogle ScholarPubMed
Croskerry, P. (2009b), “A Universal Model of Diagnostic Reasoning”, Academic Medicine, Vol. 84 No. 8, pp. 1022–1028. http://doi.org/10.1097/acm.0b013e3181ace703.CrossRefGoogle ScholarPubMed
Dubosh, N.M., Edlow, J.A., Lefton, M. and Pope, J. V. (2015), “Types of diagnostic errors in neurological emergencies in the emergency department”, Diagnosis, Vol. 2 No. 1, pp. 21–28. http://doi.org/10.1515/dx-2014-0040.CrossRefGoogle ScholarPubMed
Gigerenzer, G. and Kurzenhauser, S. (2005), “Fast and Frugal Heuristics in Medical Decision Making”, in Bilbace, R., Laird, J.D., Kenneth, L.N. and Valsiner, J. (Eds.), Science and Medicine in Dialogue: Thinking through Particulars and Universals, Greenwood Publishing Group., Praeger Westport, Connecticut, pp. 3–15.CrossRefGoogle Scholar
Graber, M.L., Franklin, N. and Gordon, R. (2005), “Diagnostic Error in Internal Medicine”, Archives of Internal Medicine, Vol. 165 No. 13, pp. 1493–1499. http://doi.org/10.1001/archinte.165.13.1493.CrossRefGoogle ScholarPubMed
Kahneman, D. (2000), “A psychological point of view: Violations of rational rules as a diagnostic of mental processes”, Behavioral and Brain Sciences, Vol. 23 No. 5, pp. 681–683. http://doi.org/10.1017/S0140525X00403432.CrossRefGoogle Scholar
Kahneman, D. and Frederick, S. (2002), “Representativeness Revisited: Attribute Substitution in Intuitive Judgment”, Heuristics and Biases, Vol. 49, pp. 49–81. http://doi.org/10.1017/cbo9780511808098.004.CrossRefGoogle Scholar
Kalra, J. (2004), “Medical errors: An introduction to concepts”, Clinical Biochemistry, Vol. 37 No. 12, pp. 1043–1051. http://doi.org/10.1016/j.clinbiochem.2004.08.007.CrossRefGoogle ScholarPubMed
Kassirer, J.P. and Kopelman, R.I. (1989), “Cognitive errors in diagnosis: Instantiation, classification, and consequences”, The American Journal of Medicine, Vol. 86 No. 4, pp. 433–441. http://doi.org/10.1016/0002-9343(89)90342-2.CrossRefGoogle ScholarPubMed
Khadilkar, P.R. and Cash, P. (2020), “Understanding behavioural design: barriers and enablers”, Journal of Engineering Design, Vol. 31 No. 10, pp. 508–529. http://doi.org/10.1080/09544828.2020.1836611.CrossRefGoogle Scholar
Kopec, D., Kabir, M.H., Reinharth, D., Rothschild, O. and Castiglione, J.A. (2003), “Human Errors in Medical Practice: Systematic Classification and Reduction with Automated Information Systems”, Journal of Medical Systems, Vol. 27 No. 4, pp. 297–313. http://doi.org/10.1023/A:1023796918654.CrossRefGoogle ScholarPubMed
Michie, S., Atkins, L. and West, R. (2014), The Behaviour Change Wheel: A Guide to Designing Interventions, Silverback Publishing, London.Google Scholar
Norman, D.A. (1981), “Categorization of Action Slips”, Psychological Review, Vol. 88 No. 1, pp. 1–15. http://doi.org/10.1037/0033-295X.88.1.1.CrossRefGoogle Scholar
Phua, D.H., Fams, E. and Tan, N.C. (2013), “Cognitive Aspect of Diagnostic Errors”, Ann Acad Med Singapore, Vol. 42 No. 1, pp. 33–41.CrossRefGoogle ScholarPubMed
Pilnick, A., Hindmarsh, J. and Gill, V.T. (2009), “Beyond ‘doctor and patient’: Developments in the study of healthcare interactions”, Sociology of Health and Illness, Vol. 31 No. 6, pp. 787–802. http://doi.org/10.1111/j.1467-9566.2009.01194.x.CrossRefGoogle Scholar
Rasmussen, J. (1982), “Human errors. A taxonomy for describing human malfunction in industrial installations”, Journal of Occupational Accidents, Vol. 4 No. 2–4, pp. 311–333. http://doi.org/10.1016/0376-6349(82)90041-4.CrossRefGoogle Scholar
Rasmussen, J. (1983), “Skills, Rules, and Knowledge; Signals, Signs, and Symbols, and Other Distinctions in Human Performance Models”, IEEE Transactions on Systems, Man and Cybernetics, Vol. 13 No. 3, pp. 257–266. http://doi.org/10.1109/tsmc.1983.6313160.CrossRefGoogle Scholar
Reason, J. (1990), Human Error, Cambridge University Press, Cambridge.CrossRefGoogle Scholar
Reason, J. (2000), “Human error: Models and management”, British Medical Journal, Vol. 320 No. 7237, pp. 768–770. http://doi.org/10.1136/bmj.320.7237.768.CrossRefGoogle ScholarPubMed
Rothschild, J.M., Landrigan, C.P., Cronin, J.W., Kaushal, R., Lockley, S.W., Burdick, E., Stone, P.H., et al. (2005), “The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care”, Critical Care Medicine, Vol. 33 No. 8, pp. 1694–1700. http://doi.org/10.1097/01.ccm.0000171609.91035.bd.CrossRefGoogle Scholar
Schattner, A. (2021), “Diagnostic errors: Under-appreciated, under-reported and under-researched”, International Journal of Clinical Practice, Vol. 75 No. 12. http://doi.org/10.1111/ijcp.14913.CrossRefGoogle ScholarPubMed
Schwartz, A. and Elstein, A. (2008), “Clinical Reasoning in Medicine”, in Higgs, J., Jones, M., Loftus, S. and Christensen, N. (Eds.), Clinical Reasoning in the Health Profession, 3rd ed., Butterworth Heinemann, Woburn, Massachusetts, pp. 223–234.Google Scholar
Simon, H.A. (1972), “Theories of Bounded Rationality”, in McGuire, C.B. and Radner, R. (Eds.), Decision and Organization, North-Holland Publishing Company, Amsterdam, pp. 161–176.Google Scholar
Simon, H.A. and Newell, A. (1958), “Heuristic Problem Solving: The Next Advance in Operations Research”, Operations Research, Vol. 6 No. 1, pp. 1–10. http://doi.org/10.1287%2Fopre.6.1.1.CrossRefGoogle Scholar
Snyder, H. (2019), “Literature review as a research methodology: An overview and guidelines”, Journal of Business Research, Vol. 104, pp. 333–339. http://doi.org/10.1016/j.jbusres.2019.07.039.CrossRefGoogle Scholar
Stanovich, K.E. (2009), “Distinguishing the reflective, algorithmic, and autonomous minds: Is it time for a tri-process theory?”, in Evan, J, St.B.T. and Frankish, K. (Eds.), In Two Minds: Dual Processes and Beyond, Oxford University Press, New York, pp. 55–88. http://doi.org/10.1093/acprof:oso/9780199230167.003.0003.CrossRefGoogle Scholar
Stanovich, K.E. (2018), “Miserliness in human cognition: the interaction of detection, override and mindware”, Thinking and Reasoning, Vol. 24 No. 4, pp. 423–444. http://doi.org/10.1080/13546783.2018.1459314.CrossRefGoogle Scholar
Stanovich, K.E. and Toplak, M.E. (2012), “Defining features versus incidental correlates of Type 1 and Type 2 processing”, Mind and Society, Vol. 11 No. 1, pp. 3–13. http://doi.org/10.1007/s11299-011-0093-6.CrossRefGoogle Scholar
Stanovich, K.E. and West, R.F. (2008), “On the Relative Independence of Thinking Biases and Cognitive Ability”, Journal of Personality and Social Psychology, Vol. 94 No. 4, pp. 672–695. http://doi.org/10.1037/0022-3514.94.4.672.CrossRefGoogle ScholarPubMed
Tversky, A. and Kahneman, D. (1974), “Judgment under Uncertainty: Heuristics and Biases”, Science, Vol. 185 No. 4157, pp. 1124–1131. http://doi.org/10.1126/science.185.4157.1124.CrossRefGoogle ScholarPubMed
Wears, R.L. (2009), “What makes diagnosis hard?”, Advances in Health Sciences Education, Vol. 14 No. 1, pp. 19–25. http://doi.org/10.1007/s10459-009-9181-3.CrossRefGoogle ScholarPubMed
West, R. and Michie, S. (2020), “A brief introduction to the COM-B Model of behaviour and the PRIME Theory of motivation”, Qeios, Vol. 1, Available at: http://www.qeios.com/ (accessed 17 April 2023) http://doi.org/10.32388/WW04E6.Google Scholar