The Moore Foundation is funding five new projects for concepts and approaches for clinical quality measures specifically targeting diagnostic excellence. The foundation announced this new funding opportunity in 2019 as part of its Diagnostic Excellence Initiative, and this will be the fourth cohort of teams to receive funding.
Twelve million Americans experience a diagnostic error each year. It is likely that each of us will experience a diagnostic error in our lifetime. Delayed or missed diagnoses result in delays in treatment, allow undiagnosed conditions to persist or even progress, and worsen outcomes. The development of clinical quality measures for diagnosis will provide clinicians and medical institutions the ability to track and measure their success and failure rates and provide them with an opportunity to solve for deficiencies and implement improvements.
Achieving excellence in diagnosis goes beyond avoiding errors and includes consideration of cost, timeliness and patient experience. Designing optimal diagnostic processes require a careful balance among these competing demands. While significant progress has been made to improve safety for medications and medical interventions over the years, work to acknowledge and improve diagnostic failure remains challenging.
The foundation’s Diagnostic Excellence Initiative aims to reduce harm from erroneous or delayed diagnoses. This initiative, and the projects of the selected grantees, will help tackle the challenge of defining standards and benchmarks for diagnostic excellence, as well as methods to measure success.
“The diverse and novel ideas presented by the clinical quality measure grantees continue to give us optimism for the future of diagnostic excellence, and this year is no different,” said Karen Cosby, M.D., program director for the Diagnostic Excellence Initiative. “These projects show great promise for measuring and improving diagnoses and ultimately improving the patient experience.”
A full list of awardees can be found below.
2022 Awardees
Acumen
David Seidenwurm, M.D., FACR
Network Medical Director at Sutter Health in Sacramento, California
Rose Do, M.D.
Chief Medical Officer, Acumen, LLC; Associate Professor, University of California Irvine; Associate Professor, University of Washington
Assessing Quality and Improving Value of Breast Cancer Screening
The application of clinically accepted metrics in breast image quality and interpretation have been associated with improved outcomes. This project will link current practice standards to policy initiatives by creating a cohesive set of measures based on the Breast Imaging Reporting and Data System (BI-RADS) Atlas®. This will allow practitioners to assess performance, outcomes, and value; engage in national policy; and work towards achieving a national standard for diagnostic excellence.
American College of Emergency Physicians
Pawan Goyal, M.D., M.H.A., FAMIA, FHIMSS, FAHIMA
Senior Vice President, Quality, American College of Emergency Physicians
John Sather, M.D.
Assistant Professor of Emergency Medicine, Yale School of Medicine
Promoting Diagnostic Excellence for Pulmonary Embolism
Pulmonary embolism is the third most common cardiovascular disease often missed. Recent research demonstrates that 4.5 percent of persons with pulmonary embolism die during the initial onset and 15.4 percent within 90 days. This project seeks to implement three complementary pulmonary embolism diagnostic quality measures in a national registry to improve accuracy, utilization, and yield. These measures will elevate diagnostic quality improvement efforts, reduce delays, and prevent missed diagnoses.
Baylor College
Natalia Khalaf, M.D., Ph.D.
Assistant Professor of Medicine, Baylor College of Medicine (BCM), Michael E. DeBakey VA Medical Center (MEDVAMC), and the Houston VA Center for Innovation in Quality, Effectiveness, and Safety (IQuESt)
@NataliaKhalaf
Caroline A. Thompson, Ph.D., M.P.H.
Associate Professor of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, and UNC Lineberger Comprehensive Cancer Center
@epicaroline
Measuring Missed Opportunities in the Diagnosis of Gastrointestinal Cancers
This project will develop two interrelated measures of missed opportunities in the diagnostic care pathways of patients with colorectal, gastric, pancreas and liver cancers: 1) potentially avoidable delays in diagnosis and 2) potentially avoidable emergency diagnoses. These measures will support our long-term goal of facilitating earlier diagnosis and treatment as well as reducing care disparities in gastrointestinal cancer.
Brigham and Women’s Hospital
Ania Syrowatka, Ph.D.
Research Scientist, Brigham and Women’s Hospital & Harvard Medical School
@AniaSyrowatka
Patricia C. Dykes, Ph.D., R.N., FAAN, FACMI
Program Director Research, Center for Patient Safety, Research and Practice, Brigham and Women’s Hospital; Associate Professor of Medicine, Harvard Medical School
@pdykesPatti
Improving Follow-up on Abnormal Cancer Screening Tests in Primary Care
This project aims to develop an electronic clinical quality measure (eCQM) to report the percentage of abnormal colorectal, breast and prostate cancer screening tests with delayed or missed diagnostic follow-up testing according to established guidelines in the primary care setting. This information can help providers and health systems ‘close the loop’ on abnormal screening tests and improve diagnostic excellence by reducing delays in cancer diagnosis.
RAND Corporation
Claire O’Hanlon, Ph.D., M.P.P.
Associate Policy Researcher, RAND Corporation
@claireeohanlon
@RANDCorporation
Sangeeta Ahluwalia, Ph.D., M.P.H.
Senior Policy Researcher, RAND Corporation; Adjunct Associate Professor of Health Policy and Management, UCLA Fielding School of Public Health
@AhluwaliaPhD
@RANDCorporation
Developing a Patient Experience Measure for Timeliness of Cancer Diagnosis
This project is a patient experience survey to measure perception of unnecessary or avoidable delay in cancer diagnosis. Patients with new cancer diagnosis of all cancer stages (including in situ, except for breast carcinoma in situ and cervical carcinoma in situ) and all cancer types (except squamous and basal cell carcinoma) are included.
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