A new perspective: blending ecological psychology and Safety II to learn from diagnostic excellence.

Diagnostic error remains a persistent patient safety challenge that linear improvement strategies alone haven't solved. This study uses ecological psychology and Safety II principles to examine diagnostic "good catch" events, interviewing four clinicians across three sessions. Facilitators of effective diagnosis included "trust but verify" admission practices, point-of-care ultrasound-enhanced exams, and the use of open spaces to foster team collaboration. The authors present the results as a framework that combines Safety II principles and ecological psychology to develop robust and pragmatic interventions to mitigate diagnostic errors.