Joint Commission issues guidance on diagnostic overshadowing

The Joint Commission last week issued guidance and recommended safety actions on diagnostic overshadowing, which occurs when clinicians attribute symptoms to an existing diagnosis instead of a potential co-morbid condition. Clinicians are more likely to engage in diagnostic overshadowing with patients who have physical disabilities or a previous diagnosis of autism, mobility disabilities and neurological deficits, as well as patients who identify as LGBTQ, or have a history of substance misuse, low health literacy and obesity. Among suggested actions, the Joint Commission urged health care systems to raise awareness of diagnostic overshadowing during clinical peer and quality assurance reviews and by discussing it in trainings and education programs. Clinicians should also use listening and interviewing techniques intended to result in better patient engagement and shared decision-making with patients, according to the guidance. (Joint Commission sentinel event alert, 6/22/22)