Advancing Diagnosis through Validated Analytics and Novel Collaborations for Excellence

Diagnostic errors are common and frequently extremely serious. Unfortunately, strategies to identify diagnostic standards and best diagnostic practices for a variety of problems are scarce.

The UH ADVANCE (Advancing Diagnosis through Validated Analytics and Novel Collaborations for Excellence) Center was established in 2022 as a Diagnostic Safety Center of Excellence to identify best practices for diagnostic evaluation of common conditions prone to diagnostic error, including the failure to:

• Establish an accurate and timely explanation of the patient’s health problem(s) or
• Communicate that explanation to the patient.¹

The focus of the UH ADVANCE Center is to tackle diagnostic problems using a data and a consensus-driven approach, including:

• Assembling a diverse, multidisciplinary team consisting of physicians, nurses, specialists in clinical data analysis, implementation scientists, and patients, to provide formal input on clinical standards and best practices;
• Implementing a four-step strategy to develop recommended diagnostic practices; and
• Sustaining the Center by creating a set of policies, methods, a future agenda, and partnerships within and outside our organization.

Our general four-step process to develop recommended practices involves:

1. Identification of problems which are common, associated with high rates of diagnostic error, and for which guidance is lacking, to examine current diagnostic practice or response to diagnostic interventions.
2. Identification of outcomes of diagnostic practices.
3. Collaboration with a panel of diagnosticians, review data about practice and outcomes and formulate recommendations.
4. Implementation of recommendations and monitoring of their impact on clinical outcomes or process improvement.

1. Committee on Diagnostic Error in Health Care; Board on Health Care Services; Institute of Medicine; The National Academies of Sciences, Engineering, and Medicine; Balogh EP, Miller BT, Ball JR, editors. Improving Diagnosis in Health Care. Washington (DC): National Academies Press (US); 2015 Dec 29. 3, Overview of Diagnostic Error in Health Care. Available from: https://www.ncbi.nlm.nih.gov/books/NBK338594/