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Diagnostic errors occur in all care settings and one in three patients will experience a diagnostic error firsthand. Research suggests that communication breakdowns during the patient-provider encounter are a leading contributor to diagnostic errors.

To promote enhanced communication and information sharing within the patient-provider encounter, the Agency for Healthcare Research and Quality has developed a toolkit. This toolkit is designed to help patients, families, and health professionals work together as partners to improve diagnostic safety.

About the Toolkit

The toolkit contains two strategies, Be The Expert On You and 60 Seconds To Improve Diagnostic Safety. When paired together, these strategies enhance communication and information sharing within the patient-provider encounter to improve diagnostic safety. Each strategy contains practical materials to support adoption of the strategy within office-based practices.

This introductory webinar describes the toolkit and strategies for implementation.

Toolkit for Engaging Patients To Improve Diagnostic Safety [11 min, 49 sec]

What Is Be The Expert On You?

Be The Expert On You is a patient-facing strategy that prepares patients and their families to tell their personal health stories in a clear, concise way. Research suggests that 79 percent of diagnostic errors are related to the patient-clinician encounter and up to 56 percent of these errors are related to miscommunication during the encounter. Environmental scan findings show that inviting patients to share their entire health story, uninterrupted, and in a way that gives clinicians the information they need can reduce diagnostic errors.

What Is 60 Seconds To Improve Diagnostic Safety?

60 Seconds To Improve Diagnostic Safety prepares providers to practice deep and reflective listening for one minute at the start of a patient-encounter. Research suggests that patients are interrupted by their providers in the first 11 to 18 seconds of telling their diagnostic story. Diagnostic safety can be improved when a provider allows a patient to tell his or her health story without interruption for one minute, and then asks questions to deepen understanding.

Ready To Start?

The Toolkit Implementation Roadmap (PDF, 311 KB) is the starting point for your implementation and should help you plan your strategy for adopting each intervention.

Step 1: Prepare Your Organization

• Toolkit Infographic (PDF, 743 KB) provides statistics about incidents of diagnostic errors that are useful to engage leadership and raise awareness of the problem.

Step 2: Make a Plan

• Be The Expert on You Planning Worksheet (PDF, 219 KB) helps teams plan to implement the patient-facing strategy.
• 60 Seconds To Improve Diagnostic Safety Planning Worksheet (PDF, 308 KB) helps teams plan to implement the provider-facing strategy.
• Evaluation Planning Tool (PDF, 205 KB) provides several recommended approaches to measure success of the toolkit and its impact on patients, providers, and practices.

Step 3: Train Your Team

• One-Page Handout for Staff Training (PDF, 138 KB) can be used to help staff get comfortable introducing the Share Your Story note sheet to patients.
• Provider Training Slides (PowerPoint, 2 MB) is a short slide presentation with speaker’s notes to help train providers on how to get started with the 60 Seconds To Improve Diagnostic Safety strategy..
• Practice Orientation and Training Slides (PowerPoint, 3 MB) can be adapted to how your practice is implementing the toolkit.

Step 4: Implement and Evaluate

• Be The Expert On You Note Sheet in English (PDF, 423 KB) and Spanish (PDF, 720 KB) provides patients with support to be ready for their visit and to share their diagnostic story with providers.
• Patient Exit Survey (PDF, 410 KB) provides a three-question survey that can be used to evaluate the impact of the toolkit from the patient’s perspective.
• 60 Seconds To Improve Diagnostic Safety Provider Feedback Survey (PDF, 225 KB) provides a short survey that can be used to evaluate the impact of the toolkit from the provider's perspective.

References

• Combined reference list (PDF, 351 KB)

Acknowledgments

Project Team

This project was led by the MedStar Health Institute for Quality and Safety under the direction of Kelly Smith, Ph.D. Email the project team.

Development Partners

The partners for this work included the MedStar Health Research Institute, Baylor College of Medicine, Clinical Directors Network, National Nurse-Led Care Consortium, and patient partners.