Using Public Deliberation to Define Patient Roles in Reducing Diagnostic Error

描述（由申请人提供）：卫生领域需要以患者为中心的策略来减少诊断错误，改善健康，挽救生命。诊断错误，或诊断错误，错过，或延迟，是一个严重的问题，在住院和门诊设置。大多数提高诊断质量的建议侧重于医生和卫生保健系统；很少有人让患者（医疗保健服务的消费者）参与预防、识别和报告诊断错误。这个创新的项目，使用公众审议来定义患者在减少诊断错误中的角色，将使用审议的方法，让医疗保健消费者和专业人员参与制定知情和实用的以患者为中心的战略，以减少可能对患者安全和医疗保健产生重大影响的诊断错误

DESCRIPTION (provided by applicant): The health field requires patient-focused strategies to reduce diagnostic error, improve health, and save lives. Diagnostic error, or diagnoses that are wrong, missed, or delayed, is a serious issue in inpatient and outpatient settings. Most proposals to improve diagnostic quality focus on physicians and healthcare systems; few engage patients - the consumers of healthcare services - in preventing, identifying, and reporting diagnostic error. This innovative project, Using Public Deliberation to Define Patient Roles in Reducing Diagnostic Error, will use deliberative approaches to engage healthcare consumers and professionals in developing informed and practical patient-focused strategies for reducing diagnostic error that are likely to have significant impacts on patient safety, healthcare delivery, and health outcomes. Specifically, the project utilizes a randomized and controlled experimental approach that involves participants from two populations (healthcare professionals and healthcare consumers). A pre-treatment survey will be administered to potential participants in both populations. Data will be used to construct four matched pair panels (two for healthcare professionals and two for healthcare consumers), a fifth unmatched panel of healthcare consumers, and a control group of healthcare professionals and consumers. All consumer panels will oversample from AHRQ priority populations. Participants in the four matched pair panels will be randomly assigned for exposure to one of two treatment conditions: (1) education about diagnostic error, or (2) education and deliberation about diagnostic error. The deliberative panels will explore the role(s) patients are willing and able to play in preventing, identifying, ad reporting diagnostic error; the strategies that should be used to enable patients to play those roles; and the systems and structures needed for patients to assume those roles. The first deliberative consumer panel will create informed recommendations about patient-focused strategies for reducing diagnostic error, which will be tested with the fifth (unmatched) deliberative consumer panel, which will also rank and prioritize the recommendations. Project evaluation will use pre-and post-test surveys administered to all panels and the control group. The evaluation design is significant and innovative because it allows for a comparison of the relative effects of no treatment, education only, and education with deliberation on both healthcare consumers and professionals. The evaluation will examine changes in perceptions, attitudes, and knowledge about diagnostic error, patient activation, health literacy, and public deliberation, among other measures. The Society to Improve Diagnosis in Medicine (SIDM) will use the recommendations to develop strategic plans, policy statements, research agendas about patient engagement in reducing diagnostic error, as well as to create a patient engagement "tool kit" for healthcare systems, providers, and consumers. After the project concludes, interviews will be conducted with key SIDM personnel to assess their perceptions of the quality and usefulness of the recommendations, as well as their plans for disseminating and implementing the recommendations.