SHM Converge Scientific Abstract ePoster Gallery-Local Implementation of a National Diagnostic Cross Check Intervention to Increase Diagnostic Excellence

Pdf Summary

This project describes a local implementation of the ADEPT (Achieving Diagnostic Excellence through Prevention and Teamwork) Diagnostic Cross Check (DXC) intervention at a hospital medicine program. Diagnostic errors in hospitalized adults are associated with higher morbidity, mortality, and cost, so the goal was to improve diagnostic reasoning through structured peer-to-peer discussion.<br /><br />The team trained 11 volunteer DXC clinicians who rotated daily on the rapid response team (RRT) pager. When an RRT occurred, the DXC clinician contacted the attending physician to offer a DXC. If no RRTs occurred by midday, the clinician proactively invited hospitalists to use DXC on cases with diagnostic uncertainty. After each DXC, both clinicians completed a post-survey.<br /><br />Early results were promising. DXC changed the diagnostic plan of care in 18% of cases. Most DXCs were completed quickly, with 76% occurring within 5 hours of an RRT. Among hospitalists who completed the intervention, 65% found it useful, and 100% said they would participate again.<br /><br />Key implementation lessons included the importance of both rapid, inbound pager-based outreach and proactive daily invitations, openness to all hospitalists regardless of whether an RRT occurred, and compensation for DXC clinicians through the faculty compensation program to support sustainability.<br /><br />Overall, the study suggests that a locally adapted DXC intervention is feasible within hospital medicine workflows, engages clinicians well, and may positively influence diagnostic decision-making. Further evaluation is underway to assess long-term sustainability and effects on diagnostic safety outcomes.

Asset Subtitle

Ellen Barbouche

Meta Tag

Author List Allison Bond, Ellen Barbouche, Jordan Kenik, Nathan Ziman

Category Research

Concept Diagnostic Cross-check

Concept Diagnostic Excellence

Concept Diagnostic Error

Concept Diagnostic Reasoning

Concept Diagnostic Uncertainty

Distinguished Non-Finalist

Presenter Organization University of Wisconsin School of Medicine and Public Health

Presenting Author Ellen Barbouche

Track Translating Research into Practice

Keywords

ADEPT

Diagnostic Cross Check

DXC

diagnostic errors

hospital medicine

rapid response team

diagnostic reasoning

peer-to-peer discussion

clinical workflow

diagnostic safety

Diagnostic Cross-check

Diagnostic Excellence

Diagnostic Error

Diagnostic Reasoning

Diagnostic Uncertainty