Research has demonstrated that diagnostic errors are the most common, catastrophic and, costly of all causes of preventable medical harm. In fact, errors in diagnosis are the most frequent cause of medical error reported by patients. In total, it’s estimated that 12 million US adults experience a diagnostic error every year in outpatient settings alone. It has also been reported that failures of diagnosis result in as many as 80,000 preventable deaths every year in US hospitals. Through a grant from the Gordon and Betty Moore Foundation, researchers from John Hopkins University and CRICO Strategies found that one in three malpractice cases that result in death or permanent disability stem from an inaccurate or delayed diagnosis and resulted in $1.8 billion in malpractice payouts over 10 years. Three quarters of diagnostic error malpractice claims were attributable to just three categories of conditions: cancer (37.8 percent), vascular events (22.8 percent) and infection (13.5 percent), referred to as the “Big 3.”
Given the magnitude of diagnostic error burden, SIDM advocates for increased attention by health systems to improving the quality of their diagnostic process. This goes beyond avoiding errors and includes consideration of accuracy, timeliness, cost, and patient convenience. Designing an optimal diagnostic process will require a careful balancing among these competing demands. Given the dearth of solutions, we believe catalyzing a "bottom up" approach, whereby frontline health professionals and patients are engaged to develop and test plausible solutions, will most likely produce the best outcomes.
Twenty grantees will be awarded grants of up to $50,000 to carry out 12-month diagnostic quality and safety improvement projects. Grantees will be asked to identify opportunities for improvement and potential interventions, evolve the interventions through small tests of change to increase their effectiveness, build the level of evidence supporting the intervention’s effectiveness, and, where appropriate, increase impact through further opportunities to “scale and spread” utilization. There will be three distinct award cycles (annual cohorts).
Areas for Improvement
While any topic related to improving diagnosis is eligible for an improvement award, two areas in particular will receive increased attention and a minimum allocation of awards. They are:
- The Big Three (see David Newman-Toker, et al. Serious misdiagnosis-related harms in malpractice claims: The “Big Three” – vascular events, infections, and cancers. Diagnosis 2019; 6(3): 227–240) 50% of awards
- Diagnostic Quality Disparities: proposals focused on how and when the visible factors of age, race/ethnicity, and/or sex, as well as other social determinants of health, influence the risk of diagnostic error. 20% of awards
Up to 30% of awards will be awarded to the OPEN category, i.e. not one of the priority areas.
How to Apply
Interested applicants are encouraged to participate in a webinar on February 21, 2020 at 12 pm EST. To be answered, questions must be submitted by February 26, 2020. All received questions and answers will be posted on the DxQI site by March 2, 2020. Questions submitted by 12:00 pm EST on February 20 will be given priority on the webinar.
Applications must be submitted online by March 30, 2020 before midnight EST. To begin an application, you will be asked to sign in to an existing SIDM account or create a new account. Once you have logged in and started an application, you will be able to save and log in at a later date to complete unfinished questions.
Submission must include:
- Completion of online application
- Two letters of support:
- One from an executive sponsor e.g., department chair or an equivalent senior leadership role within your organization
- One from any third-party partner that is deemed critical to the success of the project (if applicable).
Applications should also include complete responses to application questions, project team roster and roles, budget explained in the narrative and an uploaded Letter of Support (PDF format).
For additional guidance on the application view the application/instruction guide.
For additional questions, please e-mail us at dxqiseedgrant@ImproveDiagnosis.org.