SHM Converge Scientific Abstract ePoster Gallery-Training Hospitalists to Conduct Peer-to-Peer Diagnostic Cross-Checks: Early Multicenter Experience From the Adept Collaborative Group

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Diagnostic error is a major inpatient safety issue, but hospitalists rarely receive formal training in structured, psychologically safe peer-to-peer diagnostic discussion. The ADEPT Collaborative Group developed and piloted a 60–90 minute interactive training to prepare hospitalists to conduct real-time “diagnostic cross-checks” after rapid response events.<br /><br />The training combined three main elements: brief teaching on appreciative inquiry and motivational interviewing, review of a Diagnostic Cross-Check Tool, and six facilitated role-play scenarios. These scenarios addressed common challenges such as disengaged clinicians, hierarchy between senior and junior physicians, concerns about threatening primary clinician autonomy, and end-of-life situations. Sessions included observer feedback and structured debriefing to help participants improve wording, manage difficult interactions, and reinforce learning.<br /><br />A total of 52 hospitalists from 13 hospitals were trained, and 125 diagnostic cross-checks were completed during the pilot. The program was well received, with 90% satisfaction reported and 99% of participants saying they would participate again. The main lesson learned was that communication skill development is the most important part of the training and is essential for successful cross-checks. Appreciative inquiry was especially useful for building psychological safety, encouraging collaboration, and supporting a growth mindset. The authors also found that effective cross-checks need both structure and flexibility.<br /><br />Overall, the study shows that peer diagnostic cross-check training is feasible, adaptable across hospitals, and acceptable to hospitalists. Embedding this kind of structured reflective dialogue into hospital medicine may improve diagnostic safety and strengthen collaborative culture.

Asset Subtitle

Nathan Ziman

Meta Tag

Author List Allison Bond, Andrew D. Auerbach, Armond Esmaili, Jeffrey J. Glasheen, Jeffrey L. Schnipper, Katie E. Raffel, Molly A. Kantor, Nathan Ziman, Raymond M. Klein

Category Innovations

Concept Peer-to-Peer Diagnostic Cross-Checks

Concept Diagnostic Error

Concept Patient Safety

Concept Psychological Safety

Concept Hospitalist Training Session

Distinguished Non-Finalist

Presenter Organization University of California, San Francisco

Presenting Author Nathan Ziman

Track Patient Safety

Keywords

diagnostic safety

hospitalists

peer-to-peer training

psychological safety

diagnostic cross-check

rapid response events

appreciative inquiry

motivational interviewing

role-play scenarios

structured communication

Peer-to-Peer Diagnostic Cross-Checks

Diagnostic Error

Patient Safety

Psychological Safety

Hospitalist Training Session