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Efforts to Improve Medical Diagnosis Included in Federal Spending Bill

Posted By Amanda Staller, Monday, April 2, 2018

Congress directs AHRQ to focus attention on deadly, costly problem of inaccurate or delayed diagnoses, which claims 40,000 to 80,000 lives a year 

FOR IMMEDIATE RELEASE 

March 29, 2018 - The newly enacted federal spending bill calls improving medical diagnosis a "moral, professional, and public health imperative" and directs federal health agencies to focus attention on it. Building on research from the National Academy of Medicine (NAM), Congress used the FY 2018 federal spending bill to direct the Agency for Healthcare Research and Quality (AHRQ) to propose a strategy for improving diagnosis. By including the language in the spending bill, Congress underscored the “magnitude of [a] public health burden” that claims 40,000 to 80,000 lives each year.

Legislative documents request that AHRQ convene a cross-agency working group that will propose a strategy to enhance scientific research to improve diagnosis in healthcare, as outlined in NAM’s landmark 2015 report, Improving Diagnosis in Health Care. Congressional appropriating committees said this should include a review of current research and consider opportunities for public-private partnerships—including the development of Centers of Diagnostic Excellence—to propel research to improve diagnostic quality and safety, while reducing healthcare costs.

The NAM report identified diagnostic error as a major, unaddressed patient safety issue, summarized a wide range of contributing factors and possible interventions, and specifically called on healthcare organizations to consider their role in improving the diagnostic process. Although some promising interventions have been identified, few have been evaluated in practice. The Society to Improve Diagnosis in Medicine (SIDM) is educating policymakers on the impact of missed or erroneous diagnoses and advocating for more research funding. SIDM has assembled a coalition of dozens of groups representing health systems, patients, clinicians and others to raise awareness and spark action.

“Congress should be applauded for taking this essential first step,” said SIDM CEO Paul Epner. “The complexity of diagnosis is well known, but there are gaps in knowledge about why diagnostic errors occur, which leaves the healthcare system struggling with a response. Better understanding of the most common reasons for diagnostic inaccuracy will lead to data-driven, replicable solutions.”

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About the Society to Improve Diagnosis in Medicine (SIDM)
SIDM is a nonprofit organization whose members include clinicians and other healthcare professionals, patients and every stakeholder in the diagnostic process. In 2015, SIDM established the Coalition to Improve Diagnosis, a collaboration of more than 35 leading healthcare organizations. Visit www.improvediagnosis.org to learn more.

Tags:  diagnostic errors  funding  medical research  research 

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ECRI Institute Names Diagnostic Error Top Patient Safety Concern for 2018

Posted By Lorie Slass, Tuesday, March 13, 2018
Updated: Tuesday, March 13, 2018

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CONTACT: Lorie Slass (215) 801-4057, lorie.slass@improvediagnosis.org 

FOR IMMEDIATE RELEASE
March 13, 2018


ECRI Institute Names Diagnostic Error Top Patient Safety Concern for 2018


Statement from Paul Epner, CEO of the Society to Improve Diagnosis in Medicine

This week the ECRI Institute named diagnostic errors the top patient safety concern of 2018.  They note:

“According to both studies and claims analyses, diagnostic errors are common, and they can have serious consequences. Miscommunication is a common issue, but often not the only one. ‘It’s a multifactorial problem,’ says Gail M. Horvath, MSN, RN, CNOR, CRCST, patient safety analyst and consultant, ECRI Institute. ‘Diagnostic errors are the result of cognitive, systemic, or a combination of cognitive and systemic factors.’

Diagnostic errors are also challenging to measure and learn from because they often go undetected until after the patient leaves the hospital or emergency department (ED). Healthcare organizations should capture data on diagnostic errors and near misses. Sources may include the event-reporting system, malpractice and payment claims, patient complaints, patient surveys, autopsies, and record reviews. The organization can then make changes to address gaps. Discussing the topic in multiple forums, such as grand rounds and debriefings, can support ongoing analysis and learning for clinicians.””

The Society to Improve Diagnosis in Medicine (SIDM) applauds the ECRI Institute for calling attention to the problem of diagnostic errors and noting that it is a both cognitive and system problem.  We join them in calling on healthcare organizations to measure, report and develop initiatives to improve the diagnostic process.

SIDM is driving change through medical education, quality improvement and patient engagement initiatives to improve diagnosis.  As the convener of  the
Coalition to Improve Diagnosis, SIDM is working with the leading healthcare organizations across the country to involve patients, clinicians and health systems in efforts to reduce diagnostic error.

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The Society to Improve Diagnosis in Medicine (SIDM) catalyzes and leads change to improve diagnosis and eliminate harm from diagnostic error.  We work in partnership with patients, their families, the healthcare community and every interested stakeholder. SIDM is the only organization focused solely on the problem of diagnostic error and improving the accuracy and timeliness of diagnosis. In 2015, SIDM established the Coalition to Improve Diagnosis, to increase awareness and actions that improve diagnosis. Members of the Coalition represent hundreds of thousands of healthcare providers and patients—and the leading health organizations and government agencies involved in patient care. Together, we work to find solutions that enhance diagnostic safety and quality, reduce harm, and ultimately, ensure better health outcomes for patients. Visit  www.improvediagnosis.org to learn more. Follow us on Twitter and Facebook.


Tags:  coalition  diagnostic errors  sidm 

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Patient Safety Advocate Susan Sheridan to Join Society to Improve Diagnosis in Medicine

Posted By Lorie Slass, Tuesday, January 16, 2018
Updated: Tuesday, January 16, 2018

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CONTACT: Lorie Slass (215) 801-4057, lorie.slass@improvediagnosis.org 

 

FOR IMMEDIATE RELEASE:  January 16, 2018

 

Patient Safety Advocate Susan Sheridan to Join Society to Improve Diagnosis in Medicine

A nationally renowned leader in patient safety, Susan E. Sheridan, MIM, MBA, DHL will join the Society to Improve Diagnosis in Medicine (SIDM) on January 22, as the organization’s first-ever Director of Patient Engagement.  In this newly created position, Sheridan will spearhead efforts to ensure that the patient and family perspective informs all facets of SIDM’s work to improve diagnostic accuracy and timeliness while reducing harm caused by diagnostic errors.

Diagnostic error is one of the most important safety problems in healthcare today, and inflicts the most harm. Estimates are that one in 10 diagnoses are incorrect.

“The patient perspective is too often missing from strategies to improve healthcare delivery and reduce medical errors – including diagnostic errors,” said Paul Epner, Executive Vice President for SIDM.  “Any solution to reduce the harm and cost of diagnostic errors must integrate the patient and family perspective.  Sue is uniquely qualified to help us reach that goal.”

Since 2016 Sheridan served as on the SIDM Board and as a member of the organization’s Coalition to Improve Diagnosis – comprised of more than 30 of the leading organizations and government agencies in health care.

In 2015 the National Academies of Medicine (formerly the Institute of Medicine) issued their seminal report on diagnostic errors, Improving Diagnosis in Healthcare.  A key recommendation from the report was for health care professionals to partner with patients and their families to improve the diagnostic process. 

“Patients are now “co-developers” working with prominent research organizations, with health systems, and government agencies such as the Patient Centered Outcomes Research Institute, the Agency for Healthcare Research and Quality, and the Centers for Medicare and Medicaid Services.  But more must be done to make sure patients’ and families’ voices are heard,” said Sheridan. “I am joining the team at the Society to Improve Diagnosis in Medicine to leverage the potential of the patient engagement movement, improve diagnosis and prevent harm from diagnostic error.”

Most recently Sheridan served as the Patient and Family Engagement Adviser in the Center for Clinical Standards and Quality at the Centers of Medicare and Medicaid (CMS), where she developed strategies and processes to integrate CMS’s newly launched Person and Family Engagement Strategy throughout the CMS community.

From 2012 – 2016, Sheridan served as the Director of Patient Engagement at PCORI, where she was responsible for creating networks and engaging patients nationwide to provide broad-based input on the development and execution of PCORI’s research. She also was responsible for concept development and implementation of patient engagement-related programs and processes at PCORI.

Inspired by her own adverse family experiences in the healthcare system, Sheridan had previously spent 10 years in patient advocacy. She is Co-Founder and Past President of Parents of Infants and Children with Kernicterus, which works in partnership with private and public health agencies to eradicate kernicterus. In 2003, Sheridan co-founded Consumers Advancing Patient Safety, a nonprofit organization that seeks a safe, compassionate and just healthcare system through proactive partnership between consumers and providers of care.  Sheridan served as President of CAPS from 2003-2010.

Sheridan was asked to lead the World Health Organization’s Patients for Patient Safety initiative, a program under the WHO Patient Safety Program that embraces the collective wisdom of the patient, patient empowerment and safe, patient-centered care.  Sheridan served as Program Lead from 2004-2011.

She speaks frequently on patient engagement across the full spectrum of healthcare at national and international events.  In April 2009, Sheridan was named to Modern Healthcare's lists of Top 25 Women in Healthcare as well as 100 Most Powerful People in Healthcare.  In 2010 Sheridan was awarded the ‘Idaho Healthcare Hero’ in community outreach by the Idaho Business Review, and in 2011 Sheridan was appointed by The Secretary of Health and Human Services to serve on the Advisory Committee on Infant Mortality of the Health Resources and Services Administration for 2011-2013, as well as the CDC’s CLIAC Federal Advisory Council in 2016.  Sheridan also served on the Accreditation Council for Graduate Medical Education’s Board of Directors as a Public Director.

Sheridan received her BA from Albion College, her MIM and MBA from Thunderbird School of Global Management, and her Honorary Doctorate of Humane Letters from Adrian College.  She has a professional background in international banking and served in Ecuador with her late husband, Pat, as a Peace Corps volunteer.

About the Society to Improve Diagnosis in Medicine (SIDM)

SIDM is a nonprofit organization whose members include clinicians and other healthcare professionals, patients and every stakeholder in the diagnostic process. In 2015, SIDM established the Coalition to Improve Diagnosis, a collaboration of more than leading healthcare organizations. Visit  www.improvediagnosis.org to learn more. Follow us on Twitter and Facebook.

 

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New Articles and Editorial in DIAGNOSIS Recognize Important Role of Nurses in Diagnostic Process

Posted By Lorie Slass, Friday, December 1, 2017
Updated: Friday, December 1, 2017

 

 

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CONTACT:

Lorie Slass (215) 801-4057, lorie.slass@improvediagnosis.org

 

FOR IMMEDIATE RELEASE: December 1, 2017

 

NEW ARTICLES AND EDITORIAL IN DIAGNOSIS

RECOGNIZE IMPORTANT ROLE OF NURSES IN DIAGNOSTIC PROCESS

 

Nurses Are Critical Members of the Diagnostic Team

 

While much attention has been given broadly to the concept of teamwork in medicine, the concept of a diagnostic team is novel. Two new articles and an editorial in the latest issue of DIAGNOSIS address the importance of involving nurses in the diagnostic process as critical members of the healthcare team.

 

In their article, Defining the Critical Role of Nurses in Diagnostic Error Prevention: A Conceptual Framework and a Call to Action, authors Kelly Gleason, RN et. al. define a framework for nursing engagement in the diagnostic process “to serve as a catalyst for nurses to engage in eliminating preventable harms from diagnostic error.” It is estimated that diagnostic errors impact 12 million people each year.

 

The authors expand the concept of the triage function of nursing as “diagnostic triage,” where “nurses serve as sentinels for identifying diagnostic signs.” The authors cite one study in which greater nursing staffing in the emergency room was associated with a 50 percent reduction in time for diagnostic evaluation. The article also addresses the role of nurses in facilitating patient engagement and communication between patients and the diagnostic team. The authors identify many barriers to recognizing the unique and important role of nurses in diagnosis, including culture, education and regulation:

 

Culture – The authors call on nurses to recognize their roles in the diagnostic process, and for physicians, who have sometimes been reluctant toward nurses having an equal voice in the process, to embrace them as key participants in the diagnostic team.

 

Education – “Education and licensure requirements need to be updated to include competencies specific to the diagnostic process.” The authors suggest that interprofessional education, which is already required by licensing bodies, should be leveraged to include content specific to the diagnosis process.

 

Regulation – “As nurses embrace their role in the diagnostic process, important scope of practice issues will need to be addressed.” The authors cite the Texas Board of Nursing’s Nurse Practice Act, noting that it stipulates that “professional nursing does not include diagnosis… and that nurses may not engage in activities that require the use of independent medical judgment.”

 

The Society to Improve Diagnosis in Medicine (SIDM), through a grant from the Josiah Macy Foundation, is working on developing an inter-professional consensus curriculum on diagnosis and diagnostic error. The competency-based curriculum will support all members of the clinical team—including nurses—involved in the diagnostic process. In addition, SIDM has established a working group, led by Gleason to ensure nurses are always included as an essential member of the diagnostic team.

In the seminal 2015 report from the National Academy of Medicine, Improving Diagnosis in Healthcare, the first recommendation focused on the healthcare team: “In recognition that the diagnostic process is a dynamic team-based activity, healthcare organizations should ensure that healthcare professionals have the appropriate knowledge, skills, resources, and support to engage in teamwork in the diagnostic process.” But the roles and responsibilities of those team members were not clearly defined.

 

In The New Diagnostic Team, authored by SIDM President Mark L. Graber, MD, et. al., articulates those roles and responsibilities. “Through their unique relationship with both the patient and the physician, nursing staff are ideally situated to both support the diagnostic process and monitor its outcomes,” the authors argue.

 

Nurses provides input on the diagnostic possibilities, monitors whether communication was effective, contributes to care coordination, and observes whether the patient’s course is consistent or not with the diagnoses being considered.

 

The issue also includes a guest editorial by noted educator Julie Considine, RN, PhD. “Nurses can, do and should diagnose and have been engaged in these tasks for as long as healthcare has been in existence; the real issue is recognition of nurses as equal and legitimate members of the diagnostic team,” Considine argues.

 

DIAGNOSIS is the official journal of the Society to Improve Diagnosis in Medicine. DIAGNOSIS was launched in 2014, and was recently accepted for listing by PubMed.

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About the Society to Improve Diagnosis in Medicine (SIDM)

SIDM is a nonprofit organization whose members include clinicians and other healthcare professionals, patients and every stakeholder in the diagnostic process. In 2015, SIDM established the Coalition to Improve Diagnosis, a collaboration of 35 leading healthcare organizations. Visit www.improvediagnosis.org  to learn more. Follow us on Twitter and Facebook.

 

Tags:  Diagnostic Errors  Nurses  Patient Safety  SIDM 

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David Newman-Toker Named President-Elect of the Society to Improve Diagnosis in Medicine

Posted By Lorie Slass, Wednesday, October 11, 2017
Updated: Wednesday, October 11, 2017

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CONTACT: Lorie Slass (215) 801-4057, lorie.slass@improvediagnosis.org

 

FOR IMMEDIATE RELEASE      

October 11, 2017

 

David Newman-Toker Named President-Elect of the Society to Improve Diagnosis in Medicine

 

(BOSTON, October 11, 2017) – The Society to Improve Diagnosis in Medicine (SIDM) announced new board leadership at the 10th Annual Diagnostic Error in Medicine (DEM) Conference this week in Boston, Massachusetts. David Newman-Toker, MD, PhD, Professor of Neurology, Ophthalmology and Otolaryngology and Director of the Armstrong Institute Center for Diagnostic Excellence at Johns Hopkins Medicine, has been elected President-Elect of SIDM, effective immediately.  Serving a one-year term, Dr. Newman-Toker will become SIDM’s President in November 2018, following Dr. Mark L. Graber, SIDM’s founding President.

 

“As a member of SIDM’s Board of Directors, Dr. Newman-Toker has consistently asked the difficult questions about strategic priorities and has driven forward a strategy to raise awareness of the problem of diagnostic error among his peers and the policy community,” said Mark L. Graber, MD, President of SIDM.

Dr. Newman-Toker has served on the Board of Directors of SIDM since 2011 when SIDM was formed.  In addition to his Board position, he was conference chair for the Diagnostic Error in Medicine conference (2009-2012), initial Chair of the Research Committee (2012-2016), and currently serves as Chair of the Policy Committee. Under his Policy Committee leadership, SIDM worked throughout 2017 to educate policymakers about the importance of diagnostic safety and quality. Those efforts resulted in language in the Senate Labor, Health and Human Services, and Education Appropriations report directing the Agency for Healthcare Research and Quality to lead the development of a coordinated, multi-agency agen­da for research to improve diagnosis, a key recom­mendation of the 2015 National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) report – Improving Diagnosis in Healthcare. Dr. Newman-Toker also represents Johns Hopkins Medicine as a member of SIDM’s Coalition to Improve Diagnosis. The coalition includes representatives from 35 organizations in the medical and patient community who have committed to improving diagnostic safety and quality.

Dr. Newman-Toker holds joint appointments in Emergency Medicine and Health Sciences Informatics at the Johns Hopkins University School of Medicine, in Epidemiology and Health Policy & Management at the Johns Hopkins Bloomberg School of Public Health, and in Acute Care Nursing at the Johns Hopkins University School of Nursing. His clinical focus is in diagnosis of acute disorders affecting the brainstem and cranial nerves, particularly stroke. His personal research mission is to achieve better outcomes through better diagnosis, and he has been a pioneer in developing novel methods to diagnose stroke in patients with acute dizziness and vertigo. Dr. Newman-Toker leads the Armstrong Institute Center for Diagnostic Excellence that seeks to catalyze efforts to improve diagnostic performance, develop the science of diagnostic safety, and enhance diagnostic research.  

“The Society to Improve Diagnosis in Medicine is a small organization that is making a huge impact on the field of diagnostic safety and quality in pursuit of its vision to eliminate harms from diagnostic error. We are raising awareness of the problem, rallying stakeholders to the cause, and taking concrete actions to enhance research to reduce harms from delayed or missed diagnosis. I am very proud to be part of this critical work needed to solve this major public health problem,” said Dr. Newman-Toker.  

Dr. Newman-Toker joined more than 300 researchers, educators, physicians, clinical team members and patients at SIDM’s annual conference this week to discuss the causes of diagnostic errors and ways to improve the diagnostic process in pursuit of better diagnostic outcomes for patients. 

  

 

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About the Society to Improve Diagnosis in Medicine (SIDM)

SIDM is a nonprofit organization whose members include clinicians and other healthcare professionals, patients and every stakeholder in the diagnostic process. SIDM sponsors the annual Diagnostic Error in Medicine conference being held October 8-10, 2017 in Boston, Mass. In 2015, SIDM established the Coalition to Improve Diagnosis, a collaboration of 35 leading healthcare organizations. Visit  www.improvediagnosis.org to learn more. Follow us on Twitter and Facebook.

Tags:  DEM  Diagnostic Errors  SIDM 

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Society to Improve
Diagnosis in Medicine
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