To reduce an individuals’ propensity to be influenced by system or cognitive factors, the natural counterbalance is to adopt a team-based approach to decision making. As a result, the potential for individual biases, failed heuristics, perception deficits or environmental factors to influence diagnostic errors is reduced by including additional agents that would also need to succumb to these same erroneous ways. The risk or limitation of teams is of course the potential for groupthink where overconfidence in the group’s ability creates complacency or confirmation bias. But, this can be moderated through closed-loop communication processes, collaborative cross-checking, checklists and associated treatment protocols.

Re-consider the slippery slope of deterioration, with these additional processes earlier in the resilience time spectrum that embed proactive care through processes such as nursing change of shift huddle, bedside handover and interdisciplinary bedside rounds. These processes require staff at a minimum input the latest information for the patient and their risk states, but should also prompt staff to question the patient’s response to treatment, cross-check possible emergent risk states or deviations from the expected response to the plan of care and plan for discharge. Thus overcoming deficiencies in situation awareness that can contribute to diagnostic error or normalization of deviance, all as a matter of routine. Consequently, a new normal of the continuum of care is created, where proactive nursing change of shift processes coupled with Structured Interdisciplinary Bedside Rounds (SIBR) subtly coerce staff into proactive patient management, with identify and mitigate strategies built into the normal flow of care.