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Research News


Health Affairs Issue on Patient Safety Features HSR&D Investigator

November 8, 2018


The November 2018 issue of Health Affairs focuses on Patient Safety and features three articles by HSR&D investigator Hardeep Singh, MD, MPH, Chief, Health Policy, Quality & Informatics Program, HSR&D’s Center for Innovations in Quality, Effectiveness and Safety (IQuESt) in Houston, TX. These articles include:

  • The Institute of Medicine’s ”To Err Is Human” report, published in 1999, represented a watershed moment for the US health care system. Two Decades Since To Err Is Human: An Assessment of Progress and Emerging Priorities in Patient Safety, authored by Drs. David Bates and Hardeep Singh, discusses progress since then and highlights that despite effective interventions for safety issues such as hospital-acquired infections and medication errors, successful implementation remains hard; in addition, new safety challenges, including outpatient safety and diagnostic errors have emerged. They conclude that preventable harm remains high and recommend new scientific and policy approaches and increasing use of electronic data to move towards a “Golden Era” of patient safety.
  • In an article titled Learning from Patients’ Experiences Related to Diagnostic Errors is Essential for Progress in Patient Safety, Dr. Singh and HSR&D Houston colleague Dr. Traber Giardina analyzed a unique new data source of patient- and family-reported error narratives to explore factors that contribute to diagnostic errors. From reports of adverse medical events submitted between January 2010 to February 2016, they identified and assessed 184 unique patient narratives of diagnostic error, strengthening the case for integrating patient perspectives to inform interventions.
  • And in an article titled Payment Innovations to Improve Diagnostic Accuracy and Reduce Diagnostic Error, Drs. Berenson and Singh discuss three payment-related approaches to reducing diagnostic error, including coding changes in fee-for-service Medicare, and new Alternative Payment Models (APMs) focused on improving diagnostic accuracy and confirmation of diagnosis that triggers APMs payments. The authors suggest that the implementation of these multipronged approaches can make current payment models more accountable for addressing diagnostic error – and can position diagnostic performance as a critical component of quality-based payment.