The four-year, multimillion-dollar grant will provide support for researchers to partner with patients to co-design solutions that improve diagnostic safety.
COLUMBIA, Md. – MedStar Health has received a four-year, nearly $4M grant from the Agency for Healthcare Research and Quality (AHRQ) to establish the Patient Partnered Diagnostic Center of Excellence in collaboration with Baylor College of Medicine, University of Toronto, Michael Garron Hospital, and Mothers Against Medical Error. The grant, one of ten issued by AHRQ with the goal of addressing failures in diagnostic processes, will enable researchers to collaborate with patients to examine diagnostic safety and co-design meaningful solutions to prevent errors, improve communication between providers and their patients, and develop best practices for how healthcare organizations can support patient equity and engagement in their medical care.
Diagnostic errors are the leading cause of harm due to medical care in the U.S., with estimates suggesting that annually nearly one of every twenty patients experiences a diagnostic error. However, experts say that the underlying causes for diagnostic errors are multi-faceted and require a socio-technical systems approach to effectively address them.
"Healthcare has evolved over the past several years to focus on patient-centered care, with teams of providers working together to meet patients where they are and provide the best treatment for each individual’s needs. Yet, we haven’t seen that approach widely applied to diagnostic safety,” said Kristen Miller, DrPH, senior scientific director for MedStar Health’s National Center for Human Factors in Healthcare and Primary Investigator for this work. “Patients know more about themselves than anyone else, and their families often have a deeper understanding of how symptoms are impacting their overall lifestyle and wellbeing. This first-hand perspective can’t be overlooked. Patients and their caregivers should play a critical role in our work to advance diagnostic safety.”
Goals of the New Grant
The funding from this new grant will allow for the establishment of the Patient Partnered Diagnostic Center of Excellence, which brings together a team of seasoned researchers, clinicians, patients, and patient safety advocacy groups. Alongside collaborating partners and patients, MedStar Health researchers will investigate ways to detect and prevent diagnostic errors. Drawing upon their expertise, the co-principal investigators for this work have identified four areas of possible impact to explore:
- Designing methods to detect diagnostic safety risks and hazards from the patient’s perspective utilizing patient-reported data.
- Detecting biases within the medical record to design solutions for preventing errors among marginalized patients or patients with stigmatizing conditions.
- Improving communication of diagnoses, personalized, and tailored to individual patients from diverse backgrounds, at the point of care.
- Building guidelines to support patient equity and engagement in diagnostic safety efforts.
“Our Patient-Partnered Diagnostic Center of Excellence amplifies the important contribution of patients in achieving an accurate, timely, and communicated diagnosis. We do this by meaningfully partnering with patients and their family members to identify breakdowns in the process of diagnosis and to codesign scalable solutions,” said Kelly Smith, Ph.D., chair of patient-oriented research at Michael Garron Hospital, associate professor at the University of Toronto and co-Primary Investigator for this grant. “This grant is the culmination of the past decade of our team’s collective work to transform care through patient partnerships.”
Partnering with Patients to Improve Diagnosis
The goal of this work is to examine diagnostic safety through the lens of the patient, with research being directed by a 13-patient steering committee and an advisory panel of experts in diagnostic safety, policy, healthcare equity, and patient safety.
“This project brings together a dynamic group of people who have been working on the patient experience of diagnosis for a long time. We are excited at the thought of translating these experiences into practices and guidelines to help facilitate communication between patients and their diagnosticians,” said Helen Haskell, founder of Mothers Against Medical Error and recently retired co-chair of the World Health Organization’s Patients for Patient Safety advisory group.
Other members of the study’s patient advisory committee include Society to Improve Diagnosis in Medicine (SIDM), Project Patient Care, Citizens for Patient Safety (CPS), Patients for Patient Safety (PFPS US), Consumers Advancing Patient Safety (CAPS), the Centre for Quality Improvement and Patient Safety (CQuIPS), East Toronto Health Partners Community Council, FRAYME Groundbreakers, and the Healthcare and Patient Partner Institute (H2Pi).
Examining Disparities in Diagnostic Error
In addition to exploring diagnostic errors for patient populations at large, this work will also intentionally examine what additional challenges exist due to racial, structural, and institutional factors impacting historically marginalized patients. The research team will engage a diverse range of patients to ensure that any solutions that come from this work are meaningful and can be equitably applied across care settings, patient groups, and the clinicians who serve them.
“Our priority is centering marginalized voices in diagnostic safety. This means using an intersectional approach to examine the ways in which the diagnostic process is influenced by patients' multiple and overlapping social identities, ” said Traber Giardina, Ph.D., Assistant Professor in the Department of Medicine at Baylor College of Medicine, patient safety researcher at Center for Innovations in Quality, Effectiveness and Safety (IQuESt) at the Michael E. DeBakey Veterans Affairs Medical Center and co-Primary Investigator for the grant. “For instance, we know that marginalized patients are more likely to experience discrimination and bias in their care. How does that impact the diagnostic process and, importantly, how do we identify and eliminate it in the patient-doctor interactions.”
This AHRQ grant is a prestigious U.S. Department of Health and Human Services’ R18 Research Demonstration and Dissemination Grant and builds on MedStar Health’s longstanding commitment to a culture of safety through transparency, the highest quality of care, and zero preventable harm. Learn more.