title: Quality and Safety in Health Care, Part XII: The Work System, Testing, and Clinical Reasoning.
abstract: Donabedian felt the 3 major components affecting quality were process, structure, and outcome. Later investigators often substitute the word "structure" for a broader concept called the "work system." One component of the latter is the people involved, and for diagnosis, this often is best done with a diagnostic team. The work system in diagnosis has many obstacles to achieve optimum performance. There are also important problems with how tests are ordered and interpreted and clinical reasoning and biases.
authors.affiliation: From the Advanced Radiology Services and the Division of Radiology and Biomedical Imaging, College of Human Services, Michigan State University, Grand Rapids, MI.
authors.forename: Jay A
authors.initials: JA
authors.lastname: Harolds
mesh_terms: D002983:Clinical Competence; D003657:Decision Making; D003695:Delivery of Health Care / Q000592:standards*; D003951:Diagnostic Errors / Q000517:prevention & control; D006801:Humans; D061214:Patient Safety; D011787:Quality of Health Care; D013850:Thinking