A healthcare coalition aims to improve the quality of medical diagnoses
A coalition of more than 40 healthcare and patient advocacy organizations have launched an effort to improve the quality of medical diagnoses, especially those that can result in patient harm. Researchers estimate that up to 80,000 deaths a year in U.S. hospitals can be attributed to inaccurate or delayed diagnoses, and that diagnostic errors affect 12 million adults in outpatient settings.
ACT for Better Diagnosis™, an initiative of the Society to Improve Diagnosis in Medicine (SIDM), aims to improve the diagnostic process by calling on organizations to identify and spread practical steps to better ensure diagnoses are Accurate, Communicated and Timely.
“Nearly everyone will receive an inaccurate diagnosis at some point in their life and for some, the consequences will be grave,” Paul L. Epner, chief executive officer and co-founder of SIDM, was quoted as saying. “Major improvement is needed to systematically identify how to improve diagnostic quality and reduce harm to patients.”
Working in collaboration over several months, members of the SIDM-led Coalition to Improve Diagnosis – made up of national healthcare and patient advocacy organizations – identified initial obstacles they believe impede diagnostic accuracy, including:
- Incomplete communication during care transitions. When patients are transferred between facilities, physicians or departments, important information can slip through the cracks.
- Lack of measures and feedback. Unlike many other patient safety issues, there are no standardized measures for hospitals, health systems, or physicians to understand their performance in the diagnostic process, to guide improvement efforts or to report diagnostic errors. Providers rarely get feedback if a diagnosis was incorrect or changed.
- Limited support to help with clinical reasoning. With hundreds of potential explanations for any one particular symptom, clinicians need timely, efficient access to tools and resources to assist in making diagnoses.
- Limited time. Patients and their care providers overwhelmingly report feeling rushed by limited appointment times. This poses real risks to gathering a complete history, which is essential to formulating a working diagnosis, and allows scant opportunity to thoroughly discuss any further steps in the diagnostic process and set appropriate expectations.
- The diagnostic process is complicated. Limited information is available to patients about the questions to ask, or whom to notify when changes in their condition occur, or what constitutes serious symptoms. It’s also unclear who is responsible for closing the loop on test results and referrals, and how to communicate follow-up.
- Lack of funding for research. The impact of inaccurate or delayed diagnoses on healthcare costs and patient harm has not been clearly articulated, and there is a limited amount of published evidence to identify what improves the diagnostic process.
Members of the coalition are taking action to improve the accuracy and timeliness of diagnoses, naming tactics like providing online tools that help physicians recognize and avoid diagnostic pitfalls and improving medical education for new practitioners, as well as tools to support patients as they seek to get a diagnosis. They will also develop tools that empower doctors, patients and caregivers to communicate test results in plain language.
Coalition members include:
- ABIM Foundation
- American Society for Health Care Risk Management
- Medical Professional Liability Association
- Alliance for Academic Internal Medicine
- Association of American Medical Colleges
- MedStar Health
- American Academy of Family Physicians
- Association of Clinical Scientists
- Midwest Alliance for Patient Safety
- American Academy of Pediatrics
- Children’s Hospital of Philadelphia
- National Association of EMS Physicians
- American Association for Clinical Chemistry
- Consumers Advancing Patient Safety
- National Association of Pediatric Nurse Practitioners
- American Association of Nurse Practitioners
- Council of Medical Specialty Societies
- National Quality Forum
- American Board of Internal Medicine
- ECRI Institute
- Patient-Centered Primary Care Collaborative
- American Board of Medical Specialties
- Geisinger
- Penn State Health (Hershey Medical Center)
- American Cancer Society Cancer Action Network
- Institute for Healthcare Improvement
- Pennsylvania Patient Safety Authority
- American College of Emergency Physicians
- Intermountain Healthcare
- The Permanente Federation, Kaiser Permanente
- American College of Physicians
- Johns Hopkins Medicine
- Society of Bedside Medicine
- American Health Quality Association
- The Leapfrog Group
- Society of Hospital Medicine
- American Heart Association
- Maryland Patient Safety Center
- Society to Improve Diagnosis in Medicine
- Massachusetts Coalition for the Prevention of Medical Errors
- WomenHeart
Also participating in the coalition are federal liaisons, including the Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, and Veterans Health Administration.