Few hospitals have created surveillance programs for diagnostic errors.  Fewer have programs to translate those opportunities into improvement efforts to prevent future harm. The Achieving Diagnostic Excellence through Prevention and Teamwork (ADEPT) collaborative is a 16 site AHRQ funded project which is developing measurement frameworks for diagnostic safety, and then using these frameworks to aid with implementation of diagnostic excellence programs.  We spoke with IHQSE Faculty Dr. Katie Raffel about ADEPT and its potential impact. 


Tell us about your approach to this project?

This is a multicenter, real‐world quality and safety program utilizing interrupted time‐series techniques to evaluate diagnostic outcomes. Each of our 16 participating sites will review randomly sampled cases of rapid response events, ICU escalation or inpatient death utilizing a diagnostic safety lens. We'll systematically capture process errors that may have led to delayed, missed or wrong diagnosis and create visual benchmarking that allows sites to share their opportunity areas with institutional teams. This foundational problem understanding will then allow sites-- in later stages of the program-- to pilot process improvements aimed to enhance diagnostic workflows and accuracy. 


Why is this work important?

Diagnostic error may affect as many as 1/5 adult patients who experience care escalation or death in the hospital. In spite of its prevalence, health systems have been slow to prioritize this aspect of patient safety because of challenges with measurement and complexity of improvement.  We hope that the ADEPT cross-site collaboration creates mechanisms for identifying diagnostic opportunity, benchmarking processes/outcomes and learning about it as a health system. 


How do you think this will impact healthcare?

In addition to the diagnostic safety infrastructure that ADEPT will build within each participating site, we also believe that this collaboration will create a cadre of diagnostic safety leaders. Our vision is that this measurement/benchmarking foundation combined with multi-year diagnostic team development allows for ongoing diagnostic excellence at these sites that extends beyond the years of this initial AHRQ-funded program. 

Dr. Raffel and IHQSE Director, Dr. Jeff Glasheen co-authored and a recent publication on ADEPT in the Journal for Hospital Medicine. Read the full article here.