A coalition of more than 40 healthcare and patient advocacy organizations launched a targeted 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.
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.
Each year, diagnostic errors affect 12 million adults in outpatient settings and are the most common cause of medical errors reported by patients.
Working in collaboration over several months, members of the SIDM-led Coalition to Improve Diagnosis, made up of premier 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, 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 work over several years with all stakeholders engaged.
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.
