Purpose

Identifying nontechnical, teamwork competencies (knowledge, skills, and attitudes) underlying coordination within and across the network of teams-or multiteam system (MTS) involved in cancer care is foundational to optimizing high-quality cancer care.

Methods

A multidisciplinary group of cancer care stakeholders refined an initial list of competency statements during three rounds of a web-based modified Delphi survey.

Results

Panelists reached consensus on a final list of four domains and 20 associated team-based competencies important for effective coordination in cancer care MTS.

Conclusion

This study provides an initial foundation for testing, modifying, measuring and evaluating the impact of identified competencies on care coordination, outcomes, and costs, for people being screened, treated, or surviving cancer.

Objective

In this article, we describe some of the cognitive and system-based sources of detection and interpretation errors in diagnostic radiology and discuss potential approaches to help reduce misdiagnoses.

Conclusion

Every radiologist worries about missing a diagnosis or giving a false-positive reading. The retrospective error rate among radiologic examinations is approximately 30%, with real-time errors in daily radiology practice averaging 3-5%. Nearly 75% of all medical malpractice claims against radiologists are related to diagnostic errors. As medical reimbursement trends downward, radiologists attempt to compensate by undertaking additional responsibilities to increase productivity. The increased workload, rising quality expectations, cognitive biases, and poor system factors all contribute to diagnostic errors in radiology. Diagnostic errors are underrecognized and underappreciated in radiology practice. This is due to the inability to obtain reliable national estimates of the impact, the difficulty in evaluating effectiveness of potential interventions, and the poor response to systemwide solutions. Most of our clinical work is executed through type 1 processes to minimize cost, anxiety, and delay; however, type 1 processes are also vulnerable to errors. Instead of trying to completely eliminate cognitive shortcuts that serve us well most of the time, becoming aware of common biases and using metacognitive strategies to mitigate the effects have the potential to create sustainable improvement in diagnostic errors.