Leapfrog Group Addresses Diagnostic Errors with 29 Best Practices
By Greg Freeman
A new report includes 29 actions hospitals can implement to reduce the risk of patient harm or death from diagnostic errors. The Leapfrog Group recently released what it calls a landmark report, Recognizing Excellence in Diagnosis: Recommended Practices for Hospitals. It was derived from a year of research with clinicians, health plans, and employers.1
The report authors noted diagnostic errors contribute to 40,000 to 80,000 deaths a year.
Leapfrog will use some practices from the report to survey hospitals on their current implementation status through a national pilot in fall 2022. That information will be used to develop a new section on the Leapfrog Hospital Survey in 2024, says Missy Danforth, vice president of healthcare ratings with The Leapfrog Group.
“Within this report there are a handful of practices that any hospital could start doing immediately. We really designed this report with all hospitals in mind, not just large, urban, freestanding hospitals,” Danforth says. “The practices in this report represent a spectrum of things ranging from fundamental patient safety practices to more pioneering concepts. There are so many things that need to be done that even if you just pick three or four from the 29 and try to get started, you could make a huge difference.”
The Society to Improve Diagnosis in Medicine was a key participant in developing the best practices, Danforth says, and will develop tools and training materials for their implementation.
Each recommended practice in the report includes ways to help hospitals implement the practice, along with guidance to employers, purchasers, and patient advocates to spur hospital adoption.
Leapfrog cites these as key practices among the total:
- Create easier routes for patients and family caregivers to report diagnostic errors and concerns to the hospital. Hospitals can provide multiple routes for patients and caregivers to report errors and concerns, including patient-generated incident reporting, grievance process, patient portals and surveys, and an ombudsman. Hospitals should create a formal process to investigate and respond to the patient-reported diagnostic errors and concerns.
- Use “closed-loop” communication to ensure the ordering clinician reviews the test results timely and communicates that information to patients quickly. Written policies should outline the responsibilities of each member of the care team to ensure all test results, including those pending at discharge, are viewed by the care team and communicated to the patient in a timely manner.
- Senior administrative leaders should convene a multidisciplinary team to implement hospitalwide diagnostic quality and safety programs. The team should be led by the chief medical officer or other senior administrative leader. At a minimum, the team should include representatives from nursing, pharmacy, laboratory medicine, radiology, and the ED.
Danforth says one encouraging finding from the research is diagnostic issues are top-of-mind for healthcare leaders. The team did not need a hard sell to convince clinicians and administrators that diagnostic accuracy needs improvement.
“Not only did everyone know diagnostic errors were a major patient safety problem, but everyone had an example of one,” Danforth says. “It’s not every day in patient safety that you start with that kind of understanding and embracing of the goal. We think that because this resonates with so many people, everyone can bring their teams together and start implementing these practices.”
- The Leapfrog Group. Recognizing Excellence in Diagnosis: Recommended Practices for Hospitals. July 2022.
- Missy Danforth, Vice President of Healthcare Ratings, The Leapfrog Group, Washington, DC. Phone: (202) 292-6713.
A new report includes 29 actions hospitals can implement to reduce the risk of patient harm or death from diagnostic errors. The Leapfrog Group recently released what it calls a landmark report, Recognizing Excellence in Diagnosis: Recommended Practices for Hospitals. It was derived from a year of research with clinicians, health plans, and employers.
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