Morgan Daniel J, Singh Hardeep, Srinivasan Arjun, Bradford Andrea, McDonald L Clifford, Kutty Preeta K
Department of Epidemiology and Public Health, University of Maryland School of Medicine and VA Maryland Healthcare System, Baltimore, MD, USA.
Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, and Baylor College of Medicine, Houston, TX, USA.
Diagnosis (Berl). 2024 Nov 28;12(2):197-200. doi: 10.1515/dx-2024-0163. eCollection 2025 May 1.
Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis. To close this implementation gap, the US Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Diagnostic Excellence programs on September 17, 2024. This initiative aligns with the World Health Organization's (WHO) 2024 World Patient Safety Day focus on improving diagnosis. These Core Elements provide guidance for the formation of hospital programs to improve diagnosis and aim to integrate various disparate efforts in hospitals. By creating a shared mental model of diagnostic excellence, the Core Elements of Diagnostic Excellence supports actions to break down silos, guide hospitals toward multidisciplinary diagnostic excellence teams, and provide a foundation for building diagnostic excellence programs in hospitals.
在美国国家医学院发布《改善医疗保健诊断》报告近十年后,诊断错误仍然很常见,常常导致身体、心理、情感和经济伤害。尽管有大量关于潜在解决方案和后续步骤的研究,但这些努力在转化为患者护理方面却很有限。改进举措仍然狭隘地集中在诸如诊断管理、防止过度诊断以及加强临床推理等选择性主题上,而没有全面解决围绕诊断的脆弱系统和流程。为了弥合这一实施差距,美国疾病控制与预防中心(CDC)于2024年9月17日发布了医院卓越诊断项目的核心要素。该倡议与世界卫生组织(WHO)2024年世界患者安全日改善诊断的重点相一致。这些核心要素为医院改善诊断的项目形成提供指导,并旨在整合医院内各种不同的努力。通过创建卓越诊断的共享思维模式,卓越诊断核心要素支持采取行动打破壁垒,引导医院建立多学科卓越诊断团队,并为在医院建立卓越诊断项目提供基础。