R18HS029348

Decode: Diagnostic Excellence Center on Diagnostic Error - Abstract

We plan to establish a Diagnostic Center of Excellence that will focus on reducing diagnostic errors related to diagnostic imaging in two ways. We will: 1) implement a highly reliable and resilient system to enhance safety by reducing failures in timely performance of clinically necessary diagnostic imaging examinations and interpretative errors (Safety 2), and 2) improve diagnostic precision by building consensus using available evidence around four common causes of diagnostic errors – findings that may lead to a diagnosis of lung, prostate, pancreas, and adrenal cancer.

The DCE will build on strong pre-existing research and operational collaboration between a team of safety scientists, biomedical informaticists, and health services researchers at the Massachusetts General Brigham (MGB) Health System. MGB is comprised of 2 tertiary academic hospitals, 7 community acute care hospitals, 3 specialty hospitals, multiple ambulatory care and outpatient imaging facilities serving patients in ambulatory, inpatient, and ED settings, with a provider network of over 10,000 employed and affiliated primary care and specialty care physicians.

Recent integration at MGB has prioritized clinical integration, creating a single office of the Chief Operating Officer, a single office of the Chief Medical Officer, and a single enterprise radiology governance including for quality and safety.

We will enhance a set of pre-existing limited implementation information technology-enabled functions and workflows before MGB-wide expansion to address multiple types of diagnostic errors, including those leading to missed, incorrect, or delayed diagnoses. Enhancements will improve EHR-integration, monitoring, and learning capabilities of our clinical dashboard to better address health disparities, to help advance an equity-informed resilient system and associated workflows.

Another system for peer learning will also be implemented to target interpretive errors in diagnostic imaging. Finally, we will convene a multispecialty team of clinicians to build consensus on recommendations for diagnosis and management of findings that may lead to lung, prostate, pancreatic, and adrenal cancer based on available evidence using a modified Delphi process. Evidence that are agreed upon will be embedded in a clinical decision support system that will be integrated with the electronic health record.

All specifications for systems and workflow processes, consensus results, and lessons learned will be disseminated broadly through national conferences and meetings, a public website, networks of clinical practice and institutions, and social media.

Brigham & Womens Hospital

TO SUPPORT RESEARCH AND EVALUATIONS, DEMONSTRATION PROJECTS, RESEARCH NETWORKS, AND MULTIDISCIPLINARY CENTERS AND TO DISSEMINATE INFORMATION ON HEALTH CARE AND ON SYSTEMS FOR THE DELIVERY OF SUCH CARE INVOLVING: (1) THE QUALITY, EFFECTIVENESS, EFFICIENCY, APPROPRIATENESS AND VALUE OF HEALTH CARE SERVICES, (2) QUALITY MEASUREMENT AND IMPROVEMENT, (3) THE OUTCOMES, COST, COST-EFFECTIVENESS, AND USE OF HEALTH CARE SERVICES AND ACCESS TO SUCH SERVICES, (4) CLINICAL PRACTICE, INCLUDING PRIMARY CARE AND PRACTICE-ORIENTED RESEARCH, (5) HEALTH CARE TECHNOLOGIES, FACILITIES AND EQUIPMENT, (6) HEALTH CARE COSTS, PRODUCTIVITY, ORGANIZATION, AND MARKET FORCES, (7) HEALTH PROMOTION AND DISEASE PREVENTION, INCLUDING CLINICAL PREVENTIVE SERVICES, (8) HEALTH STATISTICS, SURVEYS, DATABASE DEVELOPMENT, AND EPIDEMIOLOGY, (9) DIGITAL HEALTHCARE RESEARCH, AND (10) PATIENT SAFETY RESEARCH, INCLUDING HEALTHCARE-ASSOCIATED INFECTIONS. IN SUPPORT OF THIS RESEARCH, THE AGENCY HAS A SPECIAL INTEREST IN HEALTH CARE AND ITS DELIVERY IN THE INNER CITY, IN RURAL AREAS, AND FOR PRIORITY POPULATIONS (LOW-INCOME GROUPS, MINORITY GROUPS, WOMEN, CHILDREN, THE ELDERLY, AND INDIVIDUALS WITH SPECIAL HEALTH CARE NEEDS).

93.226 - Research on Healthcare Costs, Quality and Outcomes

Division of Grants Management [HHS - AHRQ]

Center for Quality Improvement and Patient Safety (CQuIPS) [HHS - AHRQ]

Boston, Massachusetts 021156110 United States

Single Zip Code

Diagnostic Centers of Excellence: Partnerships to Improve Diagnostic Safety and Quality (R18) (RFA-HS-22-008)

Amendment Since initial award the total obligations have increased 300% from $992,942 to $3,975,328.