Clinician-identified problems and solutions for delayed diagnosis in primary care: a PRIORITIZE study

Area of Science:

• Patient safety
• Primary care
• Healthcare management

Background:

• Delayed diagnosis in primary care is a frequent, detrimental, and costly patient safety incident.
• Current methods for measuring and monitoring delayed diagnosis are insufficient and underutilized.
• A novel approach was developed to identify contributing factors and solutions for delayed diagnosis.

Purpose of the Study:

• To develop and implement a novel method for prioritizing patient safety problems and solutions related to delayed diagnosis in primary care.
• To identify key problems and actionable solutions for improving timely diagnosis in primary care settings.

Main Methods:

• A new priority-setting method, PRIORITIZE, was developed.
• Over 500 clinicians were surveyed for problems and solutions concerning delayed diagnosis.
• 113 clinicians submitted suggestions, which were synthesized into 33 problems and 27 solutions, then ranked by 75 clinicians.

Main Results:

• Top-ranked problems included poor inter-professional communication and the inverse care law.
• Key solutions involved better communication of abnormal results, direct specialist hotlines for GPs, and enhanced primary care clinician training.
• Improving communication among clinicians and with patients emerged as a critical priority, with high expert consensus on top suggestions.

Conclusions:

• The developed method is feasible, informative, and scalable for routine patient safety assessment.
• Clinicians suggested practical, low-investment interventions focusing on communication and training to prevent delayed diagnosis.
• Prioritized rankings can guide policymakers and commissioners in allocating healthcare resources effectively.