CLIAC policy recommendations: Autopsies; Test Result Communication.

graber.mark at GMAIL.COM graber.mark at GMAIL.COM
Thu Nov 10 16:47:45 UTC 2016


Colleagues, 

On Nov 3, the CDC-based federal advisory committee CLIAC (Clinical Lab Improvement Advisory Committee) unanimously passed recommendations with significant policy implications for diagnostic error reduction. These recommendations are listed below and are being forwarded to Department of Health and Human Services and CMS for further action.  The recommendation on improving test results communication was championed by two CLIAC members from our own community, Sue Sheridan (a SIDM Board Member and patient representative on CLIAC) and Hardeep Singh (safety researcher known for his work on diagnostic error).  Two guidance documents mentioned in the recommendation (ONC SAFER Guides and VHA policy) were co-developed by Hardeep and his team and might be useful to other institutions embarking on test results follow-up improvement initiatives.
 
More details will be available on the CLIAC website in due course: https://wwwn.cdc.gov/CLIAC/Meetings/MeetingDetails.aspx <https://wwwn.cdc.gov/CLIAC/Meetings/MeetingDetails.aspx>
 
Thanks,
Mark
 
CLIAC Communication of Test Results Recommendation
Recommendation 1a
CMS should convene a multidisciplinary group* to
–       Generate a report describing a process for health care institutions to improve safe communication and follow-up of diagnostic test results to providers and/or patients with clear guidelines on timelines for communicating those results.

–       Provide an implementation and evaluation plan for the process.

–       Examples of guidance for the report include 2015 VHA policy on communicating test results, http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3148. <http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3148.%20>
–        A similar project was the CDC’s Core Elements of Hospital Antibiotic Stewardship Programs, http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html <http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html>.

*may include, but is not limited to, representatives from CMS, FDA, CDC, diagnostic industry representatives, relevant approved accrediting organizations, informaticians, human factors engineers, laboratory directors/professionals, clinician end-users,  patient/consumer representatives, health IT developers/vendors, and other relevant professional organizations.
 
Recommendation 1b
CMS should recommend health care institutions create an interdisciplinary team comprised of clinical and diagnostic health care professionals, health IT, and other safety/human factors experts. This team should conduct periodic institutional self-assessments to address areas of risk and improvement related to safe communication and follow-up of diagnostic results.
Examples of guidance include Test Results Reporting & Follow-up ONC SAFER Guide, https://www.healthit.gov/safer/guide/sg008 <https://www.healthit.gov/safer/guide/sg008>.  
Additional guidance could be obtained from the report in Recommendation 1a
 
CLIAC Autopsy Recommendation
The CLIAC supports the IOM recommendation that Department of Health and Human Services (HHS) provide funding for a designated subset of health care systems to conduct routine postmortem examinations on appropriately defined categories of patient deaths (for example, those listed in the College of American Pathologists Guidelines for Non-Forensic Autopsies). These funds should be directly linked to proposals for data acquisition, including standardization of autopsy procedure and reporting (including death-certificates), with the express goal of understanding the value of autopsies for improving individual and health system outcomes.







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


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