Issue link: https://beckershealthcare.uberflip.com/i/1476979
88 CMO / CARE DELIVERY Joint Commission warns of 'diagnostic overshadowing' in new sentinel event alert By Erica Carbajal T he Joint Commission on June 22 issued a sentinel event alert to turn more attention to the effects of di- agnostic overshadowing — the attribution of symp- toms to an existing diagnosis instead of a possible comor- bid condition — and actions to address it. "Diagnostic overshadowing is a serious safety and quality concern as an initial misdiagnosis can have a significant impact on quality of life, including the physical and psy- chological wellness of patients," said Ana Pujols McKee, MD, executive vice president, chief medical officer, and chief diversity, equity and inclusion officer at The Joint Commission. "I urge my physician colleagues to recognize that diagnostic overshadowing stems from cognitive bias and work to reduce this through training and education programs." The quality improvement and patient safety group said diagnostic overshadowing exists among interactions be- tween clinicians and patients with physical disabilities or previous diagnoses, and others experiencing health dis- parities. The sentinel alert outlines action items to address the issue, such as listening and interview techniques de- signed to enhance patient engagement and shared deci- sion-making. n Top 25 internal medicine residencies, ranked by physicians By Kelly Gooch J ohns Hopkins University in Baltimore offers the best clinical training in internal medicine, according to Doximity's 2018- 2019 Residency Navigator. e navigator, released July 24, gives medical students insights from physicians on residency programs nationwide. Physicians contribute nominations, ratings and handwritten reviews. For the latest navigator, 29,000 physicians each nominated up to five programs based on the clinical training the program offered. is year 78,000 nominations were included. Here are the top 25 residency programs for internal medicine, based on the number of nominations received: 1. Johns Hopkins University (Baltimore) 2. Massachusetts General Hospital (Boston) 3. University of California San Francisco 4. Brigham and Women's Hospital (Boston) 5. Mayo Clinic College of Medicine and Science (Rochester, Minn.) 6. Duke University Hospital (Durham, N.C.) 7. Washington University School of Medicine; Barnes-Jewish Hos- pital; St. Louis Children's Hospital (St. Louis) 8. University of Texas Southwestern Medical Center (Dallas) 9. NewYork-Presbyterian/ Columbia University Irving Medical Center (New York City) 10. Michigan Medicine (Ann Arbor) 11. University of Washington (Seattle) 12. Vanderbilt University Medical Center (Nashville, Tenn.) 13. Stanford (Calif.) Health Care 14. McGaw Medical Center of Northwestern University (Chicago) 15. New York University School of Medicine (New York City) 16. University of Pennsylvania Health System (Philadelphia) 17. Emory University School of Medicine (Atlanta) 18. UCLA David Geffen School of Medicine/UCLA Medical Center (Los Angeles) 19. Pennsylvania Hospital of Penn Medicine (Philadelphia) 20. Cleveland Clinic Foundation 21. Beth Israel Deaconess Medical Center (Boston) 22. University of Chicago Medicine 23. NewYork-Presbyterian/Weill Cornell Medical Center (New York City) 24. Icahn School of Medicine at Mount Sinai (New York City) 25. Yale-New Haven (Conn.) Hospital Doximity members, who are verified U.S. medical students, physicians and advanced practice clinicians, may access the full navigator data here. n