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101. Federal Interagency Workgroup--Diagnostic Safety: November Meeting Summary (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/topics/dx-safety-workgroup-meeting-notes-nov2022.pdf
     March 01, 2023 - Federal Interagency Workgroup--Diagnostic Safety: November Meeting Summary Federal Interagency Workgroup … : Improving Diagnostic Safety and Quality in Healthcare November Meeting Summary Workgroup Goal: … • Diagnostic Safety Grants o Awarded 10 Diagnostic Safety Centers of Excellence grants under … NOFO Diagnostic Centers of Excellence: Partnerships to Improve Diagnostic Safety and Quality (R18) … the diagnostic safety contract and on TeamSTEPPS for Diagnosis Improvement

102. Measure Dx: Making Diagnostic Safety Your Measurement Priority (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/MeasureDx-infographic.pdf
     July 01, 2022 - Measure Dx: Making Diagnostic Safety Your Measurement Priority Measure Dx Making Diagnostic Safety … Your Measurement Priority 1 Why Diagnostic errors are common, harmful, and costly. 1 in 20 adults … will experience a diagnostic error in the outpatient setting every year.a About 250,000 harmful … diagnostic errors occur yearly in U.S. hospitals.b 2 How Identify diagnostic safety events to learn … Diagnostic Safety Create or Sustain Initiative To Learn Gather Data of Safety

103. Engaging Patients To Improve Diagnostic Safety Toolkit Roadmap (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/resources/diagnostic-toolkit/02-pfe-road-map.pdf
     August 01, 2021 - Engaging Patients To Improve Diagnostic Safety Toolkit Roadmap Toolkit for Engaging Patients To Improve … Diagnostic Safety Engaging Patients To Improve Diagnostic Safety Toolkit Roadmap This Implementation … Organization Orient leaders to the change Toolkit Infographic provides statistics about incidents of diagnostic … key questions to help your team plan how your provider team will implement the 60 Seconds to Improve Diagnostic … Provider Feedback Survey for the 60 Seconds To Improve Diagnostic Safety provides a short survey you

104. 60 Seconds To Improve Diagnostic Safety Planning Worksheet (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/resources/diagnostic-toolkit/05-pfe-planning-60-seconds.pdf
     August 01, 2021 - 60 Seconds To Improve Diagnostic Safety Planning Worksheet Toolkit for Engaging Patients To Improve … Diagnostic Safety AHRQ Publication No. 21-0047-4-EF August 2021 60 Seconds To Improve Diagnostic … Orientation and Training slides 1 Set scope � With which patients will you use the 60 Seconds To Improve Diagnostic … � How will you document the 60 Seconds To Improve Diagnostic Safety strategy in the medical record? … reflect your plans for evaluation (Slide 16) and next steps (Slides 17-18) for the 60 Seconds To Improve Diagnostic

105. Introduction | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/probabilistic-thinking1.html
     September 01, 2022 - Improved Diagnostic Accuracy Through Probability-Based Diagnosis Introduction Previous Page … Next Page Table of Contents Improved Diagnostic Accuracy Through Probability-Based Diagnosis … Introduction Fundamental Concepts for Understanding Probability Probability and the Diagnostic … occur during the diagnostic process can lead to missed or wrong diagnoses and can harm patients. … Most patients will experience diagnostic errors in their lifetime. 1 Many diagnostic errors result from

106. Introduction | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-pediatric-safety-1.html
     August 01, 2023 - Pediatric Diagnostic Safety: State of the Science and Future Directions Introduction Previous … Page Next Page Table of Contents Pediatric Diagnostic Safety: State of the Science and Future … Directions Introduction Challenges in Approaching Diagnostic Safety Unique to Children Pediatric … Diagnostic Safety Research and Initiatives Across the Care Continuum Diagnostic Safety Research Priorities … and Opportunities The Future of Pediatric Diagnostic Safety Research Conclusion References

107. Improving Diagnosis in the Context of Rurality | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-rural-healthcare2.html
     October 01, 2024 - Diagnostic Excellence in U.S. … Rural Healthcare: A Call to Action A Path to Rural Diagnostic Excellence Improving Diagnosis in the … Excellence In Rural Healthcare References Diagnostic errors pose a significant challenge … Each year, approximately 12 million U.S. adults experience a diagnostic error, leading to as many as … diagnostic excellence (timely, safe, equitable, effective, patient‐centered, and efficient care). 21

108. Getting Ready for Measurement: Overcoming Barriers and Taking Next Steps | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/state-of-science-3.html
     June 01, 2020 - Operational Measurement of Diagnostic Safety: State of the Science Getting Ready for Measurement: Overcoming … Safety: State of the Science Introduction Special Considerations for Measurement of Diagnostic Safety … Currently, measures of diagnostic performance and safety are not among these required measures, and the … While diagnostic errors occur across the spectrum of medical practice, measurement should be strategic … Ensuring reliability in diagnostic safety.

109. Use of Data and Measurement in Improving Diagnostic Safety (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/news/events/ahrq-research-summit/newman-toker-summit2016.pdf
     September 28, 2016 - Use of Data and Measurement in Improving Diagnostic Safety AHRQ Research Summit, September 28, 2016 … Use of Data and Measurement in Improving Diagnostic Safety David E. … Independent Review Verification (Effortful)  Direct observation (e.g., videotaped diagnostic encounters … Systematic Diagnostic Ascertainment (Pricey)  Routine autopsy (or radiographic autopsy) diagnoses  … No single measurement method will address the full spectrum of diagnostic errors 2.

110. The Timeline to Diagnostic Safety SIDM -Research as a Priority (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/news/events/ahrq-research-summit/graber-summit2016.pdf
     January 01, 2017 - The Timeline to Diagnostic Safety SIDM -Research as a Priority The Timeline to Diagnostic Safety SIDM … Diagnostic Safety 40,000 – 80,000 deaths/yr 2008 (DEM) ??? … George Bernard Shaw Measuring Diagnostic Errors 15 Human Factors What factors make dx easier … How can we measure diagnostic performance? … MG: Research Priorities How can we measure diagnostic performance?

111. Foundations of Diagnosis Education | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/education-dx-outcomes-2.html
     March 01, 2022 - Improving Education—A Key to Better Diagnostic Outcomes Foundations of Diagnosis Education … Previous Page Next Page Table of Contents Improving Education—A Key to Better Diagnostic Outcomes … process and causes of diagnostic errors provides important insight into what should be taught, learned … reasoning. 14 , 15 Many believe that focusing on diagnostic teams, rather than an individual, may … It is imperative that the diagnostic team acknowledge the patient as the core team member, aiming to

112. Appendix C. Interview Guide | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-current-state-apc.html
     January 01, 2024 - Current State of Diagnostic Safety: Implications for Research, Practice, and Policy Appendix C. … Interview Guide Previous Page   Table of Contents Current State of Diagnostic Safety … [Introduce team members] We are reviewing the state of the science of diagnostic safety to identify … we identified themes that encompass the current state of diagnostic safety. … The initial rapid narrative review led us to 10 domains of diagnostic safety [read through list].

113. Conclusion | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-reimagining-healthcare-teams-8.html
     July 01, 2023 - Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety … of Contents Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic … We must think carefully about how to incorporate safe and effective AI into diagnostic teams. … While the structure and function of PCA diagnostic teams have not been defined, AI is primed to become … an essential member of diagnostic teams.

114. The Patient-Clinician-Artificial Intelligence Triad | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-reimagining-healthcare-teams-5.html
     July 01, 2023 - Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety … teams brings their unique perspective and skill set to address a diagnostic problem. … Patient-clinician-AI diagnostic team With the proliferation of AI algorithms that may inform diagnostic … decision making, the structure and function of diagnostic teams are changing. … Therefore, clinicians must begin to consider how AI will inform their diagnostic decision making and

115. Introduction | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-patients-source-understanding-dx-error-vol2-2.html
     June 01, 2023 - Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors … Errors Executive Summary Introduction Eliciting Patients’ Diagnostic Experiences Using Rigorous … Methods Learning From Narratives About Diagnostic Experience Conclusion References … It also discussed recognizing the persisting impact of diagnostic mishaps on patient health, healthcare … We then extend this information to learning from safety events and diagnostic errors specifically.

116. Fundamental Concepts for Understanding Probability | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/probabilistic-thinking2.html
     September 01, 2022 - Improved Diagnostic Accuracy Through Probability-Based Diagnosis Fundamental Concepts for Understanding … Probability Previous Page Next Page Table of Contents Improved Diagnostic Accuracy … Pathway Future Vision for Probabilistic Diagnostic Decisions References Embracing … Importance of probabilistic understanding in the diagnostic process Source: Based on Stern SDC, … Chapter 1: Diagnostic Process. https://accessmedicine.mhmedical.com/content.aspx?

117. Conclusions and Next Steps | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxchecklists-6.html
     September 01, 2020 - Evidence on Use of Clinical Reasoning Checklists for Diagnostic Error Reduction Conclusions and Next … Previous Page Next Page Table of Contents Evidence on Use of Clinical Reasoning Checklists for Diagnostic … Evidence that checklists improve diagnostic accuracy is mixed (see Table 1 ), and positive effects of … checklists on diagnostic accuracy are mainly found in subgroups of cases (difficult cases) or clinicians … Can we develop checklists for diagnostic error reduction that focus on errors of execution rather than

118. MEASUREMENT OF DIAGNOSTIC ERRORS IS THE FIRST STEP TO IMPROVEMENT (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/news/events/ahrq-research-summit/singh-summit2016.pdf
     September 01, 2016 - MEASUREMENT OF DIAGNOSTIC ERRORS IS THE FIRST STEP TO IMPROVEMENT MEASUREMENT OF DIAGNOSTIC ERRORS … BMJQS 2011Singh et al JAMA IM 2012; Singh and Sittig BMJQS 2015; Singh et al Peds 2010 Approach Diagnostic … “Error” as Diagnostic “Safety” 5 Being Realistic About Future Progress 6  Measurement ready for … Little Progress Safer Dx Measurement Framework Time Ripe for Retrospective Measurements Approach Diagnostic … “Error” as Diagnostic “Safety” Being Realistic About Future Progress Thank you and Acknowledgements

119. Actions Based on Survey Results | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-culture-survey-brazil-actions.html
     August 01, 2024 - Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case … on Survey Results Previous Page Next Page Table of Contents Learning from AHRQ's Diagnostic … To increase awareness of diagnostic safety, TeamSTEPPS® for Diagnosis Improvement 5 is being used to … An additional goal is assessment and training to support local efforts to reduce diagnostic errors. … and improve their current practices related to the diagnostic process.

120. Barriers | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-reimagining-healthcare-teams-7.html
     July 01, 2023 - Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety … of Contents Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic … Intelligence Dyad The Patient-Clinician-Artificial Intelligence Triad Core Principles for the PCA Diagnostic … Addressing these challenges will require engagement from all members of the diagnostic ecosystem (Figure … Diagnostic ecosystem: factors impacting diagnostic decisions