Are health care provider organizations ready to tackle diagnostic error? A survey of Leapfrog-participating hospitals
-
David E. Newman-Toker
,
J. Matthew Austin
Abstract
Background:
A 2015 National Academy of Medicine report on improving diagnosis in health care made recommendations for direct action by hospitals and health systems. Little is known about how health care provider organizations are addressing diagnostic safety/quality.
Methods:
This study is an anonymous online survey of safety professionals from US hospitals and health systems in July–August 2016. The survey was sent to those attending a Leapfrog Group webinar on misdiagnosis (n=188). The instrument was focused on knowledge, attitudes, and capability to address diagnostic errors at the institutional level.
Results:
Overall, 61 (32%) responded, including community hospitals (42%), integrated health networks (25%), and academic centers (21%). Awareness was high, but commitment and capability were low (31% of leaders understand the problem; 28% have sufficient safety resources; and 25% have made diagnosis a top institutional safety priority). Ongoing efforts to improve diagnostic safety were sparse and mostly included root cause analysis and peer review feedback around diagnostic errors. The top three barriers to addressing diagnostic error were lack of awareness of the problem, lack of measures of diagnostic accuracy and error, and lack of feedback on diagnostic performance. The top two tools viewed as critically important for locally tackling the problem were routine feedback on diagnostic performance and culture change to emphasize diagnostic safety.
Conclusions:
Although hospitals and health systems appear to be aware of diagnostic errors as a major safety imperative, most organizations (even those that appear to be making a strong commitment to patient safety) are not yet doing much to improve diagnosis. Going forward, efforts to activate health care organizations will be essential to improving diagnostic safety.
Acknowledgments
Dr. Newman-Toker’s effort was supported by the Armstrong Institute Center for Diagnostic Excellence at Johns Hopkins University School of Medicine. Dr. Austin’s effort was partly supported through a contract with The Leapfrog Group around performance measurement in health care.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplemental Material:
The online version of this article (DOI: https://doi.org/10.1515/dx-2016-0048) offers supplementary material, available to authorized users.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- The imperative to address diagnostic safety
- Review
- Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review
- Opinion Paper
- Identifying and analyzing diagnostic paths: a new approach for studying diagnostic practices
- Original Articles
- Are health care provider organizations ready to tackle diagnostic error? A survey of Leapfrog-participating hospitals
- Medical laboratory associated errors: the 33-month experience of an on-line volunteer Canadian province wide error reporting system
- “Dr. Google” and his predecessors
- Identifying error types in visual diagnostic skill assessment
- Letters to the Editor
- Response to paper on probabilistic diagnosis
- There is no escape from using probabilities in diagnosis-making
- IgA plasmablastic large B-cell lymphoma
- Diagnostic accuracy for hybrid oncocytic/chromophobe renal cell tumors by exploiting an immunohistochemical and histochemical combined panel
Articles in the same Issue
- Frontmatter
- Editorial
- The imperative to address diagnostic safety
- Review
- Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review
- Opinion Paper
- Identifying and analyzing diagnostic paths: a new approach for studying diagnostic practices
- Original Articles
- Are health care provider organizations ready to tackle diagnostic error? A survey of Leapfrog-participating hospitals
- Medical laboratory associated errors: the 33-month experience of an on-line volunteer Canadian province wide error reporting system
- “Dr. Google” and his predecessors
- Identifying error types in visual diagnostic skill assessment
- Letters to the Editor
- Response to paper on probabilistic diagnosis
- There is no escape from using probabilities in diagnosis-making
- IgA plasmablastic large B-cell lymphoma
- Diagnostic accuracy for hybrid oncocytic/chromophobe renal cell tumors by exploiting an immunohistochemical and histochemical combined panel
