World Patient Safety Day 2024

Improving diagnosis for patient safety is the theme of this year’s World Patient Safety Day today, 17 September 2024. Diagnostic safety is multifaceted and, with a health care system that is struggling to cope with day-to-day pressures, minimising diagnostic errors is clearly a challenge to all that are involved in the delivery of healthcare. Errors in the diagnostic process can happen at any stage of the patient’s journey; sadly the WHO estimates that errors account for nearly 16% of preventable harm across healthcare systems.

The Australian Patient Safety Foundation define diagnostic error as a “diagnosis that was unintentionally delayed (sufficient information was available earlier), wrong (another diagnosis was made before the correct one), or missed (no diagnosis was ever made), as judged from the eventual appreciation of more definitive information”.

A survey run by the Patients Association and Roche Diagnostics UK and Ireland earlier this year, 90% of participating patients said it should be easier to obtain access to the diagnostic tests they need in the UK. Challenges experienced by patients taking part in the survey included a lack of available appointments, access to local testing facilities, and a lack of speed and urgency when accessing testing. That being said when testing is available other studies have pinpointed communication breakdown in terms of results between secondary and primary care as a key factor in improving the speed and accuracy of a diagnosis.

So, what can be done to improve diagnostic safety for patients? 

• A more rigorous system of communicating abnormal results of investigations to patients.
• Listening to patients is more important than ever and, as Martha’s Rule is embedded, patients, their families, and clinical staff must work together to hear the patient’s voice and act upon concerns, particularly for the deteriorating and high risk patients. 
• Supporting and enabling the workforce, ensuring their well-being and protecting psychological safety must also be a priority.
• Making full use of technology – from virtual wards to AI – to improve safety and help support the workforce.
• Learning from incidents, applying that learning across the health system to minimise re-percussive, system-based failures and missed diagnoses that may be consequent upon human error.
• Continued investment in the national Community Diagnostic Centre (CDC) Programme. Now in its third year, the programme has approved 170 CDC sites across England. As at August 2024, there were 165 operational sites in a number of settings including shopping centres and football stadiums. Offering patients a wide range of diagnostic tests with more choice on where and how they are undertaken, CDCs reduce the need for hospital visits and potentially should expedite an accurate diagnosis and the start of treatment. So far these centres have delivered over 9 million tests, checks and scans.

This is not an exhaustive list, but making some small changes within the system may well improve diagnosis for patient safety and see better outcomes for patients, with increased satisfaction for both patients and clinical staff.