AHRQ Grants for Diagnostic Error

robert bell rmsbell at ESEDONA.NET
Mon Apr 13 17:48:14 UTC 2015


Excellent point.

Where are the loyalties of the Joint Commission - are the mainly patient or hospital?  Who pays the JCs fees? I ask this as there seem to be 100s many areas where the JC could help reduce errors to a far greater extent. Accurate data collection could be a start.

Insurance carriers often are asking for approval for expensive procedures, operations, or drugs. Do they ever challenge a surgeons decision to perform an operation?  Are second opinions ever sought in those situations?  Could the Insurance Carriers be the filter that you ask for?

But let’s not forget ambulatory care diagnostic errors, which must be massive, when so many do not have the training to diagnose many of the conditions.

Rob Bell

> On Apr 13, 2015, at 10:32 AM, pgbentonmd at aol.com wrote:
> 
> Rob, Mark and SIDM,
> 
> I would like to add another very important area in which "diagnostic" errors may cause massive and irreparable patient harm. I'm talking about not an error of diagnosis, but about the misapplication of surgical treatment indications for some diagnoses.. Currently there are no barriers to posting surgery that is inappropriate (viz unnecessary or excessive) for the underlying diagnosis.
> 
>  Patients usually have given their "informed" consent to the procedure because they trusted their physician. Most physicians are trustworthy, but some surgeons looking to enhance the surgical fee treat surgically all pathology seen on the diagnostic imaging, or do the surgery prematurely. Attached, anonymized, is one example.
> 
> What we really need is a diagnosis related "appropriateness criteria" screening system at the surgery scheduling desk that the OR nurses can understand and apply, that can trigger review of questionable case postings by senior surgeons with departmental administrative responsibility for quality of care. The Department Chair will also need timely backup consultation available from specialty society Practice Guidelines Committees when needed.
> 
> Hopefully Joint Commission will face the problem and join this effort to ensure patient safety and quality care in America's accredited hospitals.
> 
> Phillip G. Benton, MD, JD
> Atlanta, Georgia
> 
> 
> -----Original Message-----
> From: robert bell <rmsbell at ESEDONA.NET>
> To: IMPROVEDX <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
> Sent: Mon, Apr 13, 2015 11:33 am
> Subject: Re: [IMPROVEDX] AHRQ Grants for Diagnostic Error
> 
> That was the point I was trying to make previously, and asking where most diagnostic errors are to be found.  In hospitals or in private specialty practice and primary care practice?
> 
> If it is thought that most diagnostic errors come from the latter, then funding should be be available there. 
> 
> Rob Bell 
> On Apr 12, 2015, at 4:24 PM, Julianne Nemes Walsh < nemeswalsh at GMAIL.COM <mailto:nemeswalsh at GMAIL.COM>> wrote:
> 
> After reviewing the grant criteria, primary care practice groups that are not attached to a higher ed institution are not eligible.   Would love to see grant opportunities available to smaller settings to stimulate more diversified opportunities for all levels of providers interested in diagnostic error.  
> 
> On Thu, Apr 9, 2015 at 9:52 PM, <graber.mark at gmail.com <mailto:graber.mark at gmail.com>> wrote: 
> This is a big day for our diagnostic safety community:  AHRQ has just issued the first-ever grant announcement that specifically targets “ Diagnostic Safety in Ambulatory Care”.  Both R01 (large grants) and R18 (small grants) will be funded under this initiative, which will be open annually until 2018.  With so many proposed, but untested interventions that have been raised, there’s many opportunities.  Go get ‘em !
> 
> Mark
> 
> Mark L Graber MD FACP
> President, SIDM  
> 
> Title:     Understanding and Improving Diagnostic Safety in Ambulatory Care: Strategies and Interventions   
> 
> Deadline Date:  Standard due dates apply: January 25, May 25, and September 25.
> 
> For details, click on the link below:
> http://www.egrants.net/Public/index.cfm?ID=17660&UserID=graber%2Emark%40gmail%2Ecom <http://www.egrants.net/Public/index.cfm?ID=17660&UserID=graber.mark@gmail.com>
> 
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> 
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> 
> Robert M. Bell, M.D., Ph.C.
> P.O. Box 3668
> West Sedona, AZ  86340-3668
> USA
> Tel: Fax: 928 203-4517
> 
> I am changing my e-mail address to  rmsbell200 at yahoo.com <mailto:rmsbell200 at yahoo.com>   
> 
> Kindly change the e-sedona e-mail above in your address book so  we stay in touch.
> 
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Robert M. Bell, M.D., Ph.C.
P.O. Box 3668
West Sedona, AZ  86340-3668
USA
Tel: Fax: 928 203-4517

I am changing my e-mail address to rmsbell200 at yahoo.com  

Kindly change the e-sedona e-mail above in your address book so we stay in touch.












Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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