The Patient-Partnered Diagnostic Center of Excellence

患者合作卓越诊断中心

• 批准号: 10642268
• 负责人: Traber L Giardina
• 金额: $ 99.76万
• 依托单位: MEDSTAR HEALTH RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2026-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642268
• 关键词: Patient; Partnered; Diagnostic; Center; Excellence

PROJECT SUMMARY Diagnostic errors are a significant public health concern and the leading cause of harm due to medical care in the U.S. Estimates suggest that one of every twenty patients seeking healthcare in the U.S. experiences a diagnostic error, half of which result in serious harm. There are many reasons for diagnostic failures. Failures in the process of diagnosis are multifocal, and may relate to patient, clinician, or systems breakdowns and lead to potential patient harm. While there have been modest improvements in reducing diagnostic error, much of this research has focused on defining the scope of the problem and developing tools for doctors to prevent errors, largely ignoring the critical role of the patient in finding and fixing errors in their own healthcare. Our teams prior work shows that patients and their families provide valuable information often missing in medical records that can inform safety problems across different care settings; this includes diagnostic safety events. Furthermore, making accurate and timely diagnoses requires a patient-centered, team-based approach involving collaboration among multiple healthcare professionals, with the patient and their family at its core and recognition of the importance of input from patients across the spectrum of patient populations. The Patient-Partnered Diagnostic Center of Excellence (the Center) will fill these gaps by conducting research that has been identified and prioritized by patients as important to advance diagnostic safety research. The Center is governed by experienced patient-partnered scientists and directed by a committee of patients and an advisory panel of experts who collectively will develop expertise in Safety I error detection and prevention to decrease diagnosis error frequency and Safety II methods of resilience to improve safer care. The Center takes the novel approach of examining diagnostic safety using a Safety I and II lens from the patient's experience of the diagnostic journey. We are committed to meaningfully partnering with minority and equity seeking communities to drive meaningful solutions with broad application for reaching historically marginalized patients. Our Center convenes around three aims, organized into four workstreams led by a co-PI/co-I with demonstrated expertise in that workstream. Our workstreams will work together to inform solution development, cocreating improvements in detection and driving diagnostic safety system resilience in partnership with diverse patients. Our Center benefits from strong scientific expertise in diverse, relevant disciplines; diverse organizational and cultural research sites partnered with care delivery systems; but most importantly meaningful engages patients and community partners in codesign of solutions to prevent diagnostic errors. The Center's findings will inform other Diagnostic Centers of Excellence and patient-centered outcomes research. Our aggressive attention to the inclusion of equity seeking populations in codesign and evaluation will yield diagnostic safety solutions that will be adopted broadly by diverse care settings, patients, and the clinicians that serve them.

项目摘要 诊断错误是一个重大的公共卫生问题，也是医疗保健造成伤害的主要原因， 美国的估计表明，每20名在美国寻求医疗保健的患者中就有一名经历了 诊断错误，其中一半导致严重伤害。诊断失败的原因有很多。故障 诊断过程是多焦点，且可能涉及患者、临床医生或系统故障，并导致 潜在患者伤害。虽然在减少诊断错误方面取得了一定的进展，但其中大部分 研究集中在确定问题的范围和为医生开发工具以防止错误， 很大程度上忽视了患者在发现和修复自己的医疗保健错误方面的关键作用。我们 团队先前的工作表明，患者及其家属提供了医疗保健中经常缺失的有价值的信息。 可以告知不同护理环境中的安全问题的记录;这包括诊断安全事件。 此外，做出准确和及时的诊断需要以患者为中心，以团队为基础的方法， 多个医疗保健专业人员之间的协作，以患者及其家人为核心， 患者群体中患者输入的重要性。患者合作伙伴 卓越诊断中心（中心）将通过开展研究填补这些空白， 患者确定并优先考虑推进诊断安全性研究的重要性。 该中心由经验丰富的患者合作科学家管理，并由患者委员会指导， 一个专家咨询小组，他们将共同开发安全I错误检测和预防方面的专业知识， 减少诊断错误频率和安全II方法的弹性，以提高更安全的护理。中心采取 使用安全I和II透镜检查诊断安全性的新方法， 诊断之旅我们致力于与少数族裔和寻求股权的人进行有意义的合作 社区推动有意义的解决方案，广泛应用于历史上被边缘化的患者。 我们的中心围绕三个目标召开会议，分为四个工作流程，由共同PI/共同I领导， 专业知识在工作流程。我们的工作流程将共同为解决方案开发提供信息，共同创造 与不同的患者合作，改善检测和驱动诊断安全系统的弹性。 我们的中心受益于强大的科学专业知识，在不同的，相关的学科;不同的组织和 文化研究网站与护理提供系统合作;但最重要的是有意义的参与患者 和社区合作伙伴共同设计解决方案，以防止诊断错误。该中心的调查结果将告知 其他卓越诊断中心和以患者为中心的结果研究。我们积极关注 在共同设计和评估中纳入寻求公平的人群将产生诊断安全解决方案， 将被各种护理环境、患者和为他们服务的临床医生广泛采用。