The Opportunity

The delivery of high-quality healthcare is predicated on accurate and timely diagnoses. Diagnostic errors that result in significant patient harm are the leading cause of medical malpractice claims in the United States. These errors account for nearly 10 percent of deaths each year, and up to 17 percent of adverse hospital events.

While most people will experience at least one diagnostic error in their lifetime, quality improvement and patient safety measurement in diagnostic error is underdeveloped. This is due in part to the difficulty of defining what constitutes a diagnostic error and recognizing when they occur. In 2016, The National Quality Forum (NQF) convened a multistakeholder committee to develop a conceptual framework for measurement of diagnostic quality and safety to identify high-priority measures or measure concepts to reduce diagnostic harm.

While this work helped to establish a shared understanding of the key areas of measurement for diagnostic quality and safety, there remains a pressing need for practical guidance in applying the framework to actual measure development.

About the Project

NQF will revisit the Diagnostic Quality and Safety Measurement Framework—specifically, the Diagnostic Processes and Outcomes domain and relevant cross-cutting themes-refining the framework as necessary and developing specific Use Cases to demonstrate how the framework can be operationalized in practice.

Objectives:

The Committee will:

• Guide the approach to the environmental scan
• Design and finalize use cases covering four key examples of potential diagnostic errors with viable solutions
• Issue recommendations for the practical application of the updated Diagnostic Process and Outcomes component of the Framework, including for viable measures to address gaps in measures of organization structures, processes, and outcomes that address the improvement of diagnostic accuracy error, as well as guidance in the form of high-priority areas for future measure development, cross-cutting themes, and prioritized measure concepts.

NQF Process:

Over a 15-month period of performance, NQF will:

• Convene a Committee of no more than 25 experts to guide the development of project deliverables. NQF will convene the Committee to discuss the key issues outlined above and provide recommendations to the field. NQF will also engage relevant stakeholder groups from NQF’s diverse membership for input throughout this effort
• Perform an environmental scan of the literature to further the understanding of the incident events of diagnostic error, and possible solutions
• Develop four Use Cases, a comprehensive resolution of a specific type of diagnostic error, that is readily applicable to multiple sectors within the healthcare system. The steps outlined to resolve the problem will cover both general and high-level considerations, as well as granular and specifically targeted devices and strategies to resolve the diagnostic error in a narrowly targeted setting or system, or with a specific population.

Funding

This project is funded under a contract with the Department of Health and Human Services. For information about the availability of auxiliary aids and services for NQF’s federally funded projects, please visit http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html

Related NQF Work:

Improving Diagnostic Quality and Safety Final Report

Contact Information:

For more information, please contact the project team at 202.783.1300 or via email at diagnosticerror@qualityforum.org.