The Leapfrog Group on Thursday released a set of 29 recommendations to help hospitals decrease diagnostic errors and "prevent harm to the patient."
According to Leapfrog, a diagnostic error is a delayed, inaccurate, or missed diagnosis, or a correct diagnosis that is not properly communicated to a patient and their family members.
"When we talk about diagnostic error, we do not mean cognitive mistakes made by one prescriber or one clinician, because everybody makes mistakes," said Leah Binder, Leapfrog president and CEO.
Each year, roughly 250,000 hospital patients experience diagnostic errors in the United States, which contribute to over 40,000 deaths in adult ICUs, Modern Healthcare reports. In addition, diagnostic errors make up one-third of severe harm malpractice claims nationwide.
According to the Society to Improve Diagnosis in Medicine, almost 75% of diagnostic errors in the United States are attributed to cancer, cardiovascular events, and infection.
To help hospitals improve patient safety and prevent diagnostic errors, Leapfrog released a report with 29 evidence-based recommendations from the nation's top experts on diagnostic excellence, including physicians, nurses, patients, health plans, and employers.
"We are addressing what can be done to prevent harm to the patient as a result of a diagnostic error. Does the health system have in place the systems and the leadership that they should?" Binder said.
"Many think that this problem is so overwhelming that they might just throw up their hands and give up," Binder said. "The goal of this report is to give hospitals a place to start."
"Clinicians and hospital leaders tell us they know diagnostic errors are harming too many patients, but they are less clear on how to fix the problem," Binder added. "Thanks to the incredible leadership of the multi-stakeholder group Leapfrog has convened, hospitals now have clarity on the steps to take. The faster hospitals act, the more lives they can save."
For the report, Leapfrog conducted a literature review to identify over 300 potential practices to address diagnostic errors. Leapfrog's Advisory Group then met to select the 29 practices that most aligned with the following guiding principles:
The recommendations were divided into two domains—organizational leadership and systems, and the diagnostic process.
The group's recommendations for organizational leadership and systems include 16 recommended practices under five subdomains:
Senior leaders must be held accountable for diagnostic safety and quality.
A hospital's culture should support diagnostic safety, quality, and transparency.
Implement processes and structures to engage patients in their care.
Implement processes and structures to identify risks and hazards in the diagnostic process.
Ensure that financial, technological, and staffing resources are allocated to support learning and improvement initiatives.
The group's recommendations for the diagnostic process include 13 recommended practices under three subdomains:
Implement processes and structures to gather accurate and complete information from patients and other sources.
Implement processes and structures to enable correct interpretation and synthesis of information.
Implement processes and structures to effectively communicate diagnostic information to patients and ensure timely and complete handoffs during care transitions.
(Devereaux, Modern Healthcare, 7/28; Leapfrog news release, 7/28; Leapfrog, "Recognizing Excellence in Diagnosis: Recommended Practice for Hospitals," 7/28)
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