Interprofessional diagnostic management teams: a scoping review protocol

BACKGROUND

Diagnostic errors are a major problem in healthcare. In 2015, the report "Improving Diagnosis in Health Care" by the National Academies of Sciences, Engineering, and Medicine (NASEM) stated that it is likely that most people will experience at least one diagnostic error in their lifetime. The report suggests implementing diagnostic management teams, including patients and their relatives, diagnosticians, and healthcare professionals who support the diagnostic process, to limit diagnostic error and improve patient safety. Implementing interprofessional diagnostic management teams (IDMT), however, is not an easy task due to the complexity of the diagnostic processes and the traditional organization of healthcare with divided departments and healthcare professional who operate in different geographic locations. As this topic is still emerging, a scoping review is ideal to determine the scope of the body of literature on IDMT, indicate the volume of literature and studies available and identify any gaps in knowledge. In a long-term perspective, this scoping review will contribute to prevent diagnostic errors and improve patient safety, for adults and children with physical health issues.

METHODS

We will conduct this scoping review in accordance with the JBI methodology and report it based on the PRISMA-ScR. We will systematically search six databases (EMBASE, PubMed, CINAHL, Academic Search Premier, SCOPUS and Web of Science) for papers published between 1985 and 2023 that describe the use of interprofessional diagnostic management teams. The participants included will be adults and children seeking diagnostic care for physical health issues. The concept studied will be interprofessional diagnostic management teams, and the context will be the diagnostic process in the healthcare system. Studies examining the diagnostic process in psychiatry, odontology or complementary medicine will be excluded. Data extraction, including key study characteristics and findings, will be done by two reviewers independently. Any disagreement will be resolved by discussion and eventually by including the two remainder reviewers.

DISCUSSION

To our knowledge, this will be the first scoping review regarding IDMT and the derived effects on diagnostic safety and can therefore be a very important contribution to improve patient safety significantly during the diagnostic process.

PROTOCOL REGISTRATION

The project is registered at Open Science Framework (OSF) with ID: osf.io/kv2n6.

Patient generated research priorities to improve diagnostic safety: A systematic prioritization exercise

BACKGROUND

Most people experience a diagnostic error at least once in their lifetime. Patients' experiences with their diagnosis could provide important insights when setting research priorities to reduce diagnostic error.

OBJECTIVE

Our objective was to engage patients in research agenda setting for improving diagnosis.

PATIENT INVOLVEMENT

Patients were involved in generating, discussing, prioritizing, and ranking of research questions for diagnostic error reduction.

METHODS

We used the prioritization methodology based on the Child Health and Nutrition Research Initiative (CHNRI). We first solicited research questions important for diagnostic error reduction from a large group of patients. Thirty questions were initially prioritized at an in-person meeting with 8 patients who were supported by 4 researchers. The resulting list was further prioritized by patients who scored questions on five predefined criteria. We then applied previously determined weights to these prioritization criteria to adjust the final prioritization score for each question, resulting in 10 highest priority research questions.

RESULTS

Forty-one patients submitted 171 research questions. After prioritization, the highest priority topics included better care coordination across the diagnostic continuum and improving care transitions, improved identification and measurement of diagnostic errors and attention for implicit bias towards patients who are vulnerable to diagnostic errors.

DISCUSSION

We systematically identified the top-10 patient generated research priorities for diagnostic error reduction using transparent and objective methods. Patients prioritized different research questions than researchers and therefore complemented an agenda previously generated by researchers.

PRACTICAL VALUE

Research priorities identified by patients can be used by funders and researchers to conduct future research focused on reducing diagnostic errors.

FUNDING

This project was funded by the Gordon and Betty Moore Foundation.