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DxQI Seed Grant Overview

The 2021 Call for Proposals is Now Closed

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.

Meet the 2021 DxQI Seed Grant Awardees

SIDM has issued the second grant round, totaling $3 million over three years, as part of the organization’s DxQI Seed Grant Program. Sixteen organizations will receive awards up to $50,000 to test interventions to improve the quality, accuracy, and timeliness of diagnoses.

Eligible Grantees*

Care-delivery systems* are eligible to apply and will typically come from the following:

  • Office-based primary care
  • Office-based specialty care
  • Clinic (e.g., urgent, acute)
  • Other ambulatory centers (e.g., surgical/imaging)
  • Community hospital
  • Academic medical center
  • Psychiatric hospital
  • Safety net hospital
  • Critical access hospital
  • VA & military centers
  • Member of integrated delivery system
  • Federally Qualified Health Centers
  • Rehab facility
  • Skilled nursing facility
  • Psychiatric hospital

*PLEASE NOTE: Organizations that do NOT provide direct patient care, such as medical equipment companies, educational institutions, physician management organizations, are not eligible to apply for a seed grant but can partner with an eligible entity as a supporting organization. While international locations are eligible to receive a grant, you will be asked to address the importance of the problem and its potential solution to the U.S. healthcare system in your proposal. Failure to demonstrate problem importance and intervention applicability will result in a denial.

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Areas for Improvement

Over the course of three years, grants will be awarded in the following categories:

  • Diagnostic Quality Disparities: Proposals that seek to reduce the risk of diagnostic error or delayed treatment and improve diagnostic quality outcomes related to health disparities associated with age, race/ethnicity, sex, and/or other social determinants of health. 40% of awards
  • Open: Topics that do not address one of the previous two areas. Up to 20% of awards

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Program Support

  • SIDM will moderate an online community established for grantees to:
    • Support shared learning across sites as challenges and barriers are identified by individual QI teams
    • Allow participating sites to share documents and engage with the SIDM QI Program Manager who will act as a virtual improvement advisor to the community for the lifecycle of the program.
  • Educational webinars on QI techniques applied to the diagnostic field will be made available
  • Limited support will be made available through ad hoc calls to help grantees overcome potential QI barriers

Program Requirements

Each organization selected will be expected to:

  • Attend a cohort kick-off webinar
  • Assure appropriate team members are actively engaged in the QI Project Core Team
  • Demonstrate ongoing leadership commitment by an Executive Sponsor
  • Submit bi-monthly status reports describing:
    • What barriers/challenges have you faced?
    • What unanticipated consequences did you encounter with this month’s tests?
    • How did you overcome those?
  • Submit formal six-month mid-project and year-end final reports
  • Participate in quarterly calls
  • Participate in the online community
  • Attend two annual QI Summits and SIDM annual conferences
  • Ensure the IRB is aware of the proposed project, if required by your organization, and appropriate authorization is obtained prior to the start of the project.

What are we looking for?

A qualifying proposal will meet the following criteria:

1. The organization and project lead represent an eligible healthcare entity where direct patient care is provided.

2. The proposed intervention can be described by one of the four categories below:

a. A well-defined problem and discovery period (maximum six months) followed by adequate time for a to-be defined intervention that will be tested and improved.

b. A well-defined intervention that will be tested and improved.

c. An implemented, but unevaluated intervention with a well-defined evaluation plan and an opportunity to improve.

d. An implemented, evaluated intervention that will be tested and improved in a novel setting or with a novel population.

3. We are looking for interventions to reduce important sources of diagnostic error that might include, but are not limited to: 

a. Cognitive interventions in patient care settings such as clinical decision support tools;

b. Systems interventions to change diagnostic processes or workflow in practice;

c. Educational interventions where the targeted outcomes of the study are improvements in diagnosis by clinicians; or

d. Other novel/innovative approaches that have the opportunity to be scaled and spread across the broader field.

4. The interdisciplinary project team should include stakeholders with the skills, competencies, and authority to execute the project plan. In addition, the team should include one or more members with qualifications and experience in QI. Projects involving IT should include appropriate operational support staff.

5. The team includes meaningful patient or family engagement (PFE) or an adequate explanation of why the team would not benefit from patient or family engagement on the proposed project. Additional guidance on meaningful PFE can be found in the FAQ’s.

6. The executive sponsor provides a letter of support that attests to EACH of the following elements (NOTE: lack of any of these elements in the Executive Sponsor letter may result in disqualification of the application):

    • Will assure timely execution of grant agreement, if funded
    • There is organizational support for the project Aims
    • The team is appropriate to meet the project Aims
    • The budget is sufficient to meet project aims on time and within scope
    • Required people and resources to meet project Aims will be available
    • Data necessary for project completion will be accessible and available
    • The sponsor will assist in overcoming unanticipated barriers/challenges that pose a threat to project completion

Download the RFP

Scoring Criteria

Note that a technical review by a limited number of people will be performed to ensure that the submission is complete, that the core project team is appropriate, and that the budget is sufficiently described. If a proposal passes this initial review, the proposal will be submitted to peer review using the criteria below.

Content Review

1. Aims, Background, and Approach

a. Do the aims utilize SMART goal attributes (Specific, Measurable, Achievable, Realistic, Timely)?

b. Does the proposal explicitly and, where possible, quantifiably justify the problem selection, i.e. describe the magnitude of the problem and establish its importance to the diagnostic process?

c. Does the proposal clearly address the importance of addressing this problem locally and for the nation-at-large?

d. Does the proposed intervention address the problem’s root causes and is relevant supporting literature is referenced? If an international location, is the applicability of the intervention to the US health system is evident?

2. Project Plan

a. Is the population receiving the intervention clearly specified and consistent with the aims?

b. Are the project plan and time allotted for planning, implementing (or testing), evaluating, and improving the intervention reasonable and appropriate?

c. Are the operational resources adequately described such as IT or other operational support, if any, from non-core team members who will be involved in implementing the intervention??

d. Are the chosen measures of effectiveness as they relate to the desired outcomes adequately described?

e. Is method for evaluation is sufficient for determining the project’s impact?

f. Is the required data readily accessible?

g. Are major milestones, including deliverables in all three phases (pre-intervention, intervention and assessment) appropriate?

3. Organizational Rationale (assessed in preliminary review)

a. Does the project team include members who have appropriate training and/or experience in quality improvement to meet the established Aims?

b. Does the identified core project team exemplify an interdisciplinary approach and address the skills, competencies, and authority needed to execute the project plan?

c. Is there meaningful patient or family involvement in this project, or where deemed to add no value, is that position justified?

4. Risks and risk mitigation

a. Does the proposal describe the potential unintended negative consequences and are the balancing measures that will be used to evaluate those negative consequences are appropriate?

b. Does the proposal describe other potential project operational challenges and strategies to address those challenges?

5. Overall, general impression

a. Is the proposed intervention feasible, scalable, spreadable, and sustainable across different settings and organizations?

b. Is the proposal consistent with the intent of the Seed Grant Program?

Frequently Asked Questions

Read FAQs below or download the PDF version. Download the informational webinar Q&A for additional information.

Eligibility

Budget Justification

Grant Decisions and Notification

Applicant Considerations and Process

The Application

Grantee Projects

SIDM has issued the second grant round, totaling $3 million over three years, as part of the organization’s DxQI Seed Grant Program. Organizations will receive awards up to $50,000 to test interventions to improve the quality, accuracy, and timeliness of diagnoses. Learn more about the:

2021 Grantees | 2020 Grantees

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Thank You to Our Grant Reiew Committee and Peer Judge Committee

*Organizations are shown for identification purposes only.

Grant Review Committee

Doug Salvador, MD, MPH – Committee Chair
Senior Vice President and Chief Quality Officer, Baystate Health

Anne Marie Benedicto, MPPA, MPH
Vice President, Joint Commission Center for Transforming Healthcare

Jeff Brown, MEd
Principal, Safer Healthcare

Brian Mittman, PhD
Research Scientist III, Division of Health Services Research & Implementation Science, Kaiser Permanente

Sarah Sampsel, MPH
Healthcare Quality Consultant, SLSampsel Consulting, LLC

Lucy Savitz, PhD, MBA
Vice President, Health Research, Kaiser Permanente Northwest

Gordy Schiff, MD
Associate Director, Center for Patient Safety Research and Practice, Brigham and Womens Hospital

Suz Schrandt, JD
Senior Patient Engagement Advisor, Society to Improve Diagnosis in Medicine

Ron Wyatt, MD, MHA
VP and Patient Safety Officer, MCIC-Vermont

Peer Judge Committee

Vonda Vaden Bates
CEO 10th Dot, Patient Safety Advocate

Daniel L. Berg
Philanthropic Advisor, The Minneapolis Foundation

Kristie Burnette, RN, MSN, CPHQ, CPPS
Director, Patient Safety and Quality, Virginia Hospital and Healthcare Association

Claudia Butler, MBA, CPC, ELI-MP, CPHQ, CSSMBB
Consultant and Leadership Coach, Core Connections LLC

Fred M. Castello, MD, MBA (retired)
Pediatrician and Former VP Medical Affairs and Chief Medical Officer, Augusta Health

Karen Harris, RN, MSN, CPHQ, CPPS
Division Director Clinical Quality, HCA Capital Division

Harry Hoar, MD
Pediatric Hospitalist, Director of Clinical Reasoning Education, Baystate Health

Karen M Johnson, BSN, RN, CCMSCP
Sr. Director Patient Safety, Baystate Health

Kirti Joshi, M.D. FACP
Academic Hospitalist and Medical Director, Patient Safety, Baystate Medical Center

G. Michael Lynch, M.D., FAAFP, CPXP, CPHQ
Principal, G. Michael Lynch, M.D. HealthCare Consulting, L.L.C.

Timothy J. Mosher, MD
Chair, Department of Radiology, Penn State Health Milton S Hershey Medical Center

Suz Schrandt, JD
Senior Patient Engagement Advisor, Society to Improve Diagnosis in Medicine

Nelson Toussaint
President, Tamarac LLC

Divvy Kant Upadhyay, MD, MPH
Scientist and Program Manager, (Quality, Safety & Patient Experience), Geisinger