The Patient-Partnered Diagnostic Center of Excellence

项目总结 诊断错误是一个重大的公共卫生问题，也是医疗保健造成危害的主要原因 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人经历了 诊断错误，其中一半会造成严重危害。诊断失败的原因有很多。中的故障 诊断过程是多焦点的，可能与患者、临床医生或系统故障有关，并导致 可能会对病人造成伤害。虽然在减少诊断错误方面有了一些小的改进，但大部分 研究的重点是确定问题的范围并为医生开发防止差错的工具， 在很大程度上忽视了患者在发现和修复自己医疗保健中的错误方面的关键作用。我们的 团队先前的工作表明，患者及其家人提供了经常在医疗中缺失的有价值的信息 可向不同护理环境的安全问题提供信息的记录；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，包括 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和认可 认识到来自不同患者群体的信息的重要性。患者-伴侣 卓越诊断中心(该中心)将通过开展已被 被患者识别和优先考虑对推进诊断安全性研究很重要。 该中心由经验丰富的与患者合作的科学家管理，并由患者和 一个由专家组成的顾问小组，他们将共同发展安全I错误检测和预防方面的专业知识，以 减少诊断错误频率和安全第二种复原力方法，以提高更安全的护理。该中心采取 从患者的经验看使用安全I和II透镜检查诊断安全性的新方法 诊断之旅。我们致力于与少数人和寻求股权的人建立有意义的伙伴关系 社区推动有意义的解决方案，广泛应用于接触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，组织成四个工作流程，由一个联合PI/联合I领导，并演示 该工作流程中的专业知识。我们的工作流将共同为解决方案开发提供信息，共同创建 与不同的患者合作，提高检测和驾驶诊断安全系统的弹性。 我们的中心受益于不同相关学科的强大科学专业知识；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吸引患者 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向 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 将寻求公平的人群纳入联合设计和评估将产生以下诊断安全解决方案 将被不同的护理机构、患者和为他们服务的临床医生广泛采用。

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.