Taking Action to Close the Loop on Diagnostic Error: A Constellation and SIDM Collaborative

Update: Due to the impact the COVID-19 pandemic is having on our nation and the health care community, we are postponing the launch of the Collaborative until a later date. 

Constellation, a medical professional liability (MPL) insurance company, and the Society to Improve Diagnosis in Medicine (SIDM) have joined together to create a new Quality Improvement (QI) Collaborative focused on closing the loop on test results.

Almost half of Constellation member diagnosis-related malpractice claims involve follow-up system failures. This new Collaborative will begin to support clinics, hospitals, and health systems in implementing quality improvement initiatives focused on closing the loop on test results and follow-up care. In the stages of test/result processing and follow-up/coordination, there are multiple opportunities to improve the diagnostic process, including but not limited to:

• tracking receipt of reports on all tests ordered,
• improving the timeliness of action on results,
• clinician follow-up with the patient about results,
• referral/consult management, and
• patient information communicated among the care team.

“Investing time and resources in reengineering diagnostic workflows, implementing reliable HIT systems and boosting communication processes will not only help reduce diagnostic errors; it will also help create stronger care teams, increase efficiency and productivity, and improve the diagnostic process,” said Laurie Drill-Mellum, MD Chief Medical Officer, Vice President for Patient Safety, Constellation.

The Collaborative will use an Institute for Healthcare Improvement learning model for QI Collaboratives including virtual educational sessions, time for workflow improvement, and data collection and reporting. By June 2021, through a series of webinars, coaching calls, and in-person meetings, participants will be able to show improvement in a QI project aimed at closing the loop on key diagnostic process steps.

As part of the Constellation/SIDM Collaborative, participants will join a SIDM-managed virtual community to share work, update progress, raise questions, and join conversations in a forum. In addition, they will have access to a QI coach who will spend time with each team. In-person meetings will foster peer-to-peer learning and networking with local and national peers working to reduce diagnostic errors.

“We need to drive quality improvement in diagnosis and begin to test ideas that support system change,” said Paul Epner, CEO of the Society to Improve Diagnosis in Medicine. “We are pleased to partner with Constellation to tackle one driver of diagnostic errors – failure to close the loop on test results. We expect that these QI projects will lead to specific approaches that other hospitals, health systems, or clinics can replicate to reduce harm from diagnostic errors.”

Participants will collect and submit data to be shared on monthly calls among participants for improvement purposes. Quality improvement teams may include physicians, quality and safety leaders, department managers, nursing, lab, or HIT personnel.

Clinic, hospital, or health system teams interested in improving the diagnostic process can join. While there is a $2,000 participation fee, there is limited availability of a $1,500 grant per organization to offset the participation fee. Visit www.ctlqi.org to learn more.