NQF Final Repot - Improving Diagnostic Quality & Safety

Mark Graber Mark.Graber at IMPROVEDIAGNOSIS.ORG
Fri Sep 22 21:01:02 UTC 2017

The National Quality Forum has just released its final report on “Improving Diagnostic Quality and Safety”.  This was a major project aimed at our weak spot: how to measure diagnostic performance and safety.  The report uses the IOM diagnostic process framework as the starting point for developing a comprehensive list of measure concepts that would be relevant and appropriate for further development. These include structure-, process-, and outcome-related measurement areas.

The next step will require ‘measure developers’ to begin creating specific, quantifiable measures that could be used.  The report identified these areas as the most ‘important and feasible in the near term’:

  *   Timely follow-up of test results
  *   Patient access to information;
  *   Hand-offs; and
  *   Diagnostic quality improvement activities.

The report is emerging at a time when there is growing ‘measure fatigue’, and push-back from clinicians and organizations about having too much measurement, and measures that ‘don’t matter’.  However, the potential for measurement to improve diagnosis is very real, and at the present time measures related to treatment and management outnumber those related to diagnosis by about 500/1 (my estimate).  It is my hope that we concentrate on developing diagnosis-related measures that DO matter, and the NQF report will become the foundation for this work.


Mark L Graber MD FACP
President, SIDM
Senior Fellow, RTI International
Professor Emeritus, Stony Brook University

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