Moore Foundation Advances Work in Clinical Quality Measures to Improve Diagnosis

The Gordon and Betty Moore Foundation has a mission to improve the experiences and outcomes of patient care. The foundation’s Diagnostic Excellence Initiative is focused on work to reduce harm from diagnostic errors and improve quality in diagnosis. This work is framed around a philosophy of diagnostic excellence, acknowledging that many healthcare quality goals exist in tension with one another. Health quality goals for accuracy, timeliness, patient-centeredness, safety, efficiency, and equity sometimes require tradeoffs and a nuanced balance to achieve optimal diagnosis. Assessments about quality of diagnosis may be difficult, but that shouldn’t prevent action. While philosophers debate, the Moore Foundation accepts the challenge to begin to find ways to improve.

The foundation’s Diagnostic Excellence Initiative is grounded in the goal to improve measurement for diagnostic quality through the development of clinical quality measures that can help define standards for diagnostic excellence, guide improvement efforts, and strengthen public accountability. Providers and healthcare systems want to provide excellent care, but many simply don’t know where to start or what they can do to improve diagnosis. Judgements about quality in diagnosis have largely eluded standardization and measurement.

In an attempt to address this “measurement gap,” the Moore Foundation recently launched a third request for proposals to fund development of clinical quality measures for diagnostic excellence. Details about work underway from the first two cohorts of grantees in measure development are available on Moore.org (see cohort 1 and cohort 2). The current funding opportunity will give priority to proposals addressing the “big three” health care conditions, which are responsible for a majority of preventable harm from missed or delayed diagnosis:

• acute vascular conditions (such as acute coronary syndromes, strokes, thromboembolic events, and aortic emergencies),
• infections (such as pneumonia and sepsis, as well as urinary tract infections, skin and soft tissue infections, meningitis, and spinal epidural abscesses), and
• cancers (lung cancer, colorectal cancer, as well as other common cancers).

Up to eight grants will be awarded $250,000 - $500,000 each for work done over 18 months. Submissions from individuals with deep clinical experience and content expertise are encouraged, and while measure development experience is useful, it is not a prerequisite for funding. Grantees will be supported in the work of measure development through a technical assistance partnership with Battelle. This strategy aims to promote meaningful measures that are useful and desired by frontline providers and patients. Online applications are due May 10. Individuals interested in applying for the current funding for measure development are invited to register for the April 12 informational webinar by submitting their desire to attend to diagnosis@moore.org.