Take 2 - Think, Do
Take 2 - Think, Do is a framework to support accurate diagnostic decision-making in complex clinical environments. The framework assists clinicians to recognise when there may be a high risk for diagnostic error to occur and provides a structured process that facilitates a more detailed case review at key times in the patients' journey.
The framework consists of the following components:
- Take 2 minutes to deliberate the diagnosis - promotes a quick reflection that ensures the critical elements of diagnosis have been captured for each clinical presentation.
- Think about when to take a closer look - provides clinicians with insight into high risk clinical situations in which it may be appropriate to take a closer look or re-evaluate the diagnosis.
- Do something in these high risk situations - provides clinicians with the strategies to take a closer look by outlining approaches that aid decision making. This includes individual and team based strategies to critically appraise the decision making process.
This framework promotes reflective safe diagnostic process by increasing clinician knowledge and awareness of the cognitive risks associated with decision making during diagnosis. The strategies outlined provide support, structure and guidance to decision making. This ensures all the key factors have been considered for each clinical presentation and the worst case scenario is flagged and ruled out.
The following resources have been developed to support facilities and clinicians with the Take 2 – Think, Do framework;
The Red Team / Blue Team Challenge
The Red Team / Blue Team Challenge provides tools and a structure for clinicians to safely question and challenge the diagnostic decision making process within a team environment. The strategy is developed and adapted from the military red team blue team exercises used for testing force readiness.
In the clinical environment, blue team members undertake history taking, clinical assessment and synthesis in the traditional manner, while red team members are tasked with questioning the decision making, identifying 'red flag' symptoms and symptoms that don't fit and then suggesting possible alternative diagnoses.
The strategy outlines:
- Guidelines for establishing the Red Team / Blue Team Challenge within clinical teams
- A series of prompts that the red team member may consider when critically analysing the clinical scenario
- Ground rules for establishing a safe environment
- Identified opportunities for challenge
The following resources have been developed to support facilities and clinicians with the Red Team / Blue Team Challenge:
- Red Team / Blue Team Challenge Information for clinicians ~245KB
- Red Team Blue Team sample prompt card ~293KB
Two video resources for Red Team / Blue Team Challenge have been developed. One video provides an overview of the Red Team / Blue Team Challenge in progress highlighting the key focus points of the challenge. The other video highlights triggers for commencing a Red Team / Blue Team Challenge in the clinical environment.