Publications

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May 1, 2024

Diagnostic error may result in serious harm for more than 500,000 patients and contribute to an estimated 10% of all patient deaths. Understanding diagnostic accuracy is crucial for improving patient outcomes and ensuring effective healthcare delivery. IHQSE Faculty, Drs. Michelle Knees and Katie Raffel, along with colleagues from the University of Colorado Division of Hospital Medicine, recently published an AHRQ Issue Brief aimed at furthering efforts to enhance diagnostic accuracy. The brief reviews a substantial body of literature on the impact of cognitive load on diagnostic accuracy, identifies areas for future research, and provides recommendations for integrating existing knowledge into current practice.

Apr 21, 2024

IHQSE faculty, Dr. Michael Tchou, is lead author on a research article published in Journal of Hospital Medicine. The study examines rates of overuse of diagnostic testing in pediatric hospital settings and its ripple effect of negative impacts on both providers and patients.

Apr 15, 2024

IHQSE faculty member, Dr. Katie Raffel, along with Dr. Katie Brooks and the UPSIDE research team, recently published findings from a multicenter retrospective cohort study evaluating the association between use of stigmatizing language and diagnostic error. The prevalence of stigmatizing language was higher among patients with diagnostic errors than those without. Use of this language was associated with delays in care at presentation and errors in communication with patients and caregivers. This raises the question of whether stigmatizing language may be indicative of clinician biases that interfere with data gathering, communication, and clinical reasoning.

Jan 8, 2024

Diagnostic error is common, morbid, and mortal. IHQSE faculty member, Dr. Katie Raffel, along with Dr. Andrew Auerbach and other experts on diagnostic error, recently published findings from a multicenter retrospective cohort study in which 2500 hospitalized adults who experienced ICU escalation or death were evaluated for diagnostic error. This study adds to a body of literature highlighting the importance of diagnostic safety within hospital medicine.

Dec 6, 2023

Faced with rising maternal mortality, the first prenatal visit is essential but, in many cases, important topics are missed. An IHQSE small grant supported the redesign of the first visit, dividing it into a nurse-led telemedicine visit and an in-person visit with an obstetric clinician. Clinic no-shows dropped (9.9%-4.2%), the topics covered in the first prenatal visit increased (70.0%-95.6%), and improvements were observed for all key themes.

Dec 1, 2023

Physical therapy (PT) in inpatient settings is a limited and valuable resource. Inappropriate PT consultation is costly and can lead to delays in care and discharge planning. A team of IHQSE alumni, including faculty members, Dr. Emily Gottenborg and Dr. Moksha Patel, dug into the root causes of unnecessary PT consultations and deployed an intervention that reduced the rate of inappropriate PT consults to less than 10%.

Oct 7, 2023

Few hospitals have created surveillance programs for diagnostic errors. Fewer have programs to translate those opportunities into improvement efforts to prevent future harm. IHQSE faculty Drs. Katie Raffel and Jeff Glasheen are part of the ADEPT working group funded through an AHRQ grant to build such a program. In this paper the authors share the methodology for building the surveillance program, creating the benchmarking dashboards, understanding the areas of opportunity, and building interventions. The program is live in 16 US hospitals.

Sep 26, 2023

A recent study by IHQSE alumna Jessica Kenny, PhD found that 7% of adolescents endorsed suicidal ideation (SI) in the most recent two weeks during a primary care visit. Multiple interventions were associated with reductions in SI frequency at a follow-up visit, including PCP referral to integrated behavioral health and family navigators, behavioral health providers conducting a risk assessment, completing a safety plan, involving caregivers, sending the adolescent to the emergency department when indicated, and referring to family navigators. The findings from this study support screening for SI and highlight specific multidisciplinary and family-centered interventions and recommendations to address adolescent endorsement of SI in pediatric primary care settings.

Aug 3, 2023

Recent IHQSE graduate Shannon Acker, MD, was an author on an article published by JAMA advocating for better support systems for trainees during pregnancy and early parenthood. In addition to new policies from the Accreditation Council for Graduate Medical Education, Dr. Acker and her colleague emphasize the importance of a cultural shift and a comprehensive network of support for your parents.

Aug 1, 2023

IHQSE Alumna Diane Christopher, MD, was the lead author on a study investigating the current state of quality and patient safety (QPS) efforts in OB/GYN departments in the U.S. Dr. Christopher and her colleagues found that while departments leaders responded overwhelmingly positively regarding work to improve patient safety, most QPS committee leaders received neither protected time nor financial support, and formal training was required in less that one-third of the departments. The study also found that most departments monitored key performance indicators (KPI) for inpatient outcomes, but only half tracked outpatient KPI. Dr. Christopher and her colleagues concluded that OB/GYN departments should invest more resources in QPS efforts to fully realize the benefits to providers, patients, and hospitals.