لقد حان الوقت لتغيير المسار: استخدام التدابير التي يتم الإبلاغ عنها من قبل المرضى لتحقيق سلامة المرضى والتميز التشخيصي

Since the landmark report To Err is Human by the National Academies in 1999, leaders in US health care have been acutely aware of the system's fractured structure, wide variations in care, and the harm experienced by patients. Despite some progress, the sobering reality is that improvements in patient safety have stagnated over the past two decades. Among the growing concerns is the significant harm attributable to diagnostic errors such as misdiagnoses, and missed and delayed diagnoses, that impact many patients and disproportionately harm vulnerable populations.

Recently, efforts such as the CMS ruling on a Patient Safety Structural Measure and The Leapfrog Group’s addition of the diagnostic safety section to their annual hospital safety survey have raised the bar for improving patient and diagnostic safety. However, to truly drive change, we must rethink our approach to better understand the magnitude and scope of harm, the contributing factors that lead to that harm, and the potential solutions to mitigate that harm. The answer lies in learning directly from patients about their experiences with patient and diagnostic safety through patient-reported experience (PRE) and patient-reported outcome (PRO) measures. 

The Power of Patient-Reported Measures

Patient-reported measures provide a comprehensive, real-life understanding of patients’ care, essentially “telling the story” that data sources often miss. While conventional metrics offer only snapshots of safety events, PREs and PROs capture the lived experience of patients, shedding light on patterns and opportunities for improvement that might otherwise go unnoticed.

A promising new project is underway to address this gap. 

Project PIVOT: What It Is and How It Can Help

Project PIVOT, an innovative patient-driven initiative, is leading the charge to redefine how patient feedback shapes patient safety and diagnostic excellence. Conceived by Patients for Patient Safety US, an emerging coalition of patients, patient groups, and other key stakeholders committed to safer care, Project PIVOT aims to advance the integration of patient-reported experiences (PRE) and patient-reported outcomes (PRO) into safety and quality assessment and research measurement tools – ultimately improving safety, diagnostic accuracy, timeliness, and health equity. 

Project PIVOT will produce: 

• A list of universal survey questionnaire items (PREs and PROs) prioritized by a diverse patient community for potential integration into standardized tools such as Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).
• A list of population-specific survey questionnaire items (PREs and PROs) that address unique challenges faced by groups such as older adults, people with disabilities, and birthing persons of color who experience disparities in their maternal care experience.
• A list of PREs and PROs that have been identified and prioritized by leaders of health care systems. 

The Impact of Project PIVOT

Project PIVOT aims to drive meaningful improvements and outcomes by:

• Expanding patient-centered safety and quality improvement initiatives and research.
• Introducing new timeframes and modalities for reporting patient-reported experiences (PRE) and patient-reported outcomes (PRO).
• Increasing the transparency around PREs and PROs, enabling patients, consumers, and purchasers to compare hospitals.
• Encouraging financial incentives for health care systems to improve safety, diagnostic accuracy, and equity.
• Supporting government policies that create safer, more equitable health care, particularly for vulnerable populations.

Join Project PIVOT at the IHI Patient Safety Congress

Project PIVOT will be featured at the IHI Patient Safety Congress during the Rise and Shine session (RS00) on March 10. During this session, Project PIVOT leadership will provide an overview of the initiative, present preliminary data from both patients and health care system professionals, and discuss how stakeholders can engage in the project going forward.

Attendees will also have the opportunity to participate in interactive polling, helping to shape potential new survey questions aimed at improving patient safety, diagnostic accuracy, timeliness, and equity – particularly for birthing persons of color, older adults, and people with disabilities.

Whether you are a patient, health care professional, policymaker, or advocate, your insights are invaluable. Join us on this transformative journey. Together, we can make health care safer and more equitable for all.

Marty Hatlie, JD, is the Director of Policy and Advocacy at PFPS US. Sue Sheridan, MBA, MIM, DHL, is the President and CEO of PFPS US. Divvy Upadhyay, MD, MPH, is the Program Manager, Safety Diagnosis, Geisinger Health.

Photo by rawpixel.com

You may also be interested in:

• IHI Patient Safety Congress
• Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care