40+ Healthcare Organizations Launch Coalition to Improve Care
PHILADELPHIA – The ABIM Foundation has joined a coalition of more than 40 healthcare and patient advocacy organizations to launch a targeted effort to improve the quality of medical diagnosis. Researchers estimate that up to 80,000 deaths a year in U.S. hospitals can be attributed to inaccurate or delayed diagnoses.
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.
“Providing an accurate medical diagnosis is complex and involves uncertainty, but it’s obviously essential to effective and timely treatment,” said Paul L. Epner, CEO and co-founder of SIDM. “Nearly everyone will receive an inaccurate diagnosis at some point in their life and for some, the consequences will be grave. Major improvement is needed to systematically identify how to improve diagnostic quality and reduce harm to patients.”
Each year, diagnostic errors affect 12 million adults in outpatient settings and is the most common cause of medical errors reported by patients. Members of the SIDM-led Coalition collaborated over several months to identify a number of obstacles believed to impede diagnostic accuracy, including:
- Incomplete communication during care transitions—When patients are transferred between facilities, physicians or departments, there is potential for important information to 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, which poses real risks to gathering a complete history that 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—There is limited information 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.
The organizations behind the effort—representing clinicians, patients, health systems, researchers and testing professionals—acknowledge that improvement will require sustained effort from engaged stakeholders over several years.
Coalition members will implement various tactics through their current, individual organizational efforts. Some will provide online tools that help physicians recognize and avoid diagnostic pitfalls, others are working to improve medical education for new doctors and nurses. Others are developing tools that empower doctors, patients and caregivers to communicate test results in plain language.
The FY 2018 Omnibus Appropriations Act included language emphasizing that improved diagnosis is a “moral, professional, and public health imperative” and requested that “the Agency for Healthcare Research and Quality (AHRQ) convene a cross-agency working group to propose a strategy to enhance scientific research to improve diagnosis in healthcare.” The report also recommended including consideration of opportunities for public-private partnerships and the development of centers of excellence to propel research forward to improve diagnostic quality and safety.
As a part of the ACT for Better Diagnosis initiative, the ABIM Foundation’s Choosing Wisely ® campaign provides clinicians and patients with recommendations about overused tests, treatments and procedures, which can increase the potential for patient harm.
The campaign promotes conversations about appropriate and avoiding the harms associate with unnecessary care, including misdiagnosis and financial harm.
“Promoting evidence-based medicine is crucial to combating overuse in health care, as demonstrated by the many successes of our Choosing Wisely campaign to reduce unnecessary treatments, tests and procedures. High-value care and excellence in practice are hallmarks of medical professionalism, a central commitment of the ABIM Foundation,” said Daniel B. Wolfson, Executive Vice President and COO of the Foundation.
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.
ACT for Better Diagnosis is supported by the Gordon & Betty Moore Foundation and The Mont Fund. More information is available at www.BetterDiagnosis.org.
About ACT for Better Diagnosis™
ACT for Better Diagnosis, an Initiative of the Society to Improve Diagnosis in Medicine, includes many of the nation’s leading healthcare and patient organizations collaborating as part of the Coalition to Improve Diagnosis. Together, the groups are working to improve the diagnostic process, educating healthcare leaders, patients and policymakers on the impact of missed or erroneous diagnoses and advocating for more research funding. The initiative is made possible with support from the Gordon & Betty Moore Foundation and The Mont Fund. Visit www.BetterDiagnosis.org to learn more.
About the Society to Improve Diagnosis in Medicine (SIDM)
The Society to Improve Diagnosis in Medicine catalyzes and leads change to improve diagnosis and eliminate harm from diagnostic error. We work in partnership with patients, their families, the healthcare community and every interested stakeholder. SIDM is the only organization focused solely on the problem of diagnostic error and improving the accuracy and timeliness of diagnosis. In 2015, SIDM established the Coalition to Improve Diagnosis, to increase awareness and actions
that improve diagnosis. Members of the coalition represent hundreds of thousands of healthcare providers and patients—and the leading health organizations and government agencies involved in patient care. Together, we work to find solutions that enhance diagnostic safety and quality, reduce harm, and ultimately, ensure better health outcomes for patients. Visit www.ImproveDiagnosis.org to learn more.