Digital collaboration tools can support clinical safety improvements

Early and accurate diagnosis is a strong foundation for good clinical practice and an essential first step to maximising patient outcomes and ensuring the highest standards of clinical safety. Diagnostic errors can lead to delayed or inappropriate treatment, cause unnecessary suffering, disability or, in the worst case, death. It was acknowledged in the National Institute of Medicine in 2015 that “… most of us will experience at least one diagnostic error in our lifetime, sometimes with devastating consequences”.[1]

Diagnostic errors can also lead to prolonged hospital stays, repeat testing, and increased costs for patients and the healthcare system.

To minimise harm for patients, clinical safety in diagnostics and more widely in care delivery can be improved through implementing the right processes, technology, and training.

Focus on patient safety and quality improvement

The World Patient Safety Day in 2024 was themed around improving diagnosis for patient safety and focused on systemic factors such as communication failures, heavy workloads and ineffective teamwork.

The World Health Organisation, as part of the annual campaign, committed to working with stakeholders to prioritise diagnostic safety and adopt a multifaceted approach to strengthen systems, design safe diagnostic pathways, support health workers in making correct decisions, and engage patients throughout the entire diagnostic process.

NHS England’s Getting it Right First Time (GIRFT) programme focuses on improving the treatment and care of patients through specialty workstreams examining data analysis and sharing best practice to identify changes and improve patient outcomes.

Access to diagnostics

Diagnostic activity forms part of over 85% of clinical pathways. The NHS spends over £6bn a year on over 100 diagnostic services and with this carries out an estimated 1.5 billion diagnostic tests.

Demand has been rising over the past decade as hospital referrals and attendances have been increasing. Coupled with staff shortages in diagnostics – for example, the Independent Review of Diagnostic Services for NHS England estimated that 3,500 extra radiographers were needed by 2025 – ensuring patient safety is maintained or improved is an ever-increasing challenge.

Community diagnostic centres (CDCs), established by the Government in 2021, were championed to increase access to diagnostic tests, lead to earlier diagnosis and reduce the pressure on hospitals. As at August 2024, 165 sites were operational, but they still have a long way to go to address the delays for patients. As the 2024 All-Party Parliamentary Group for Diagnostics report highlighted, it’s not just about the bricks and mortar or volume of tests carried out – there is a lot more work needed to integrate CDCs into the wider healthcare ecosystem to ensure better, more efficient clinical pathways, particularly in terms of the digital infrastructure.

Data sharing for clinical decision making

Technology can help to alleviate the delays for patients but it also has a role to play in improving clinical safety in diagnostics.

Ensuring that clinicians have access to a complete and accurate patient history is crucial to help minimise diagnostic errors.  At Feedback Medical, with our expertise in medical imaging and decades collaborating with clinicians, we understand its importance. We have integrated a summary view of patient histories from the primary care record within Bleepa®, so that secondary care and other clinicians can review and use it to inform decisions about patient care. This should reduce duplication and the need for patient’s to repeat any details to multiple clinicians that they see.

What’s also important is to enable clinicians at all stages of the patient pathway to be able to view and understand the diagnostic results to provide safe and effective care for patients.

Other technology-based solutions can help to support accurate diagnosis, including decision support tools and AI-powered diagnostic aids. A 2020 UK study showed that an AI system for breast cancer diagnosis interpreted mammograms with an absolute reduction in false positives and false negatives by 5.7% and 9.4%, respectively.

Multidisciplinary collaboration

Diagnosis is a complex process involving multiple clinicians, patients, families, and caregivers, along with laboratory, pathology, and radiological testing.

Fostering collaboration between clinicians, specialists, and other healthcare professionals involved in the care of patients is an important part of improving clinical safety in diagnostics. Clinicians need to have the right tools in place and the time to confer with colleagues and be able to raise any safety concerns, errors or queries, particularly for more junior staff to be able to raise questions with senior colleagues.

Asynchronous working via digital platforms like Bleepa®, can facilitate communication and, with access to all the diagnostic information relevant to the patient in one place, can speed up decision making without overburdening clinicians. In other words, clinicians do not need real-time interaction, they can review reports, images and respond to queries when it’s convenient for them but without unnecessary delay, as in the case of scheduling face-to face-meetings or speaking directly over the phone.

Learning from diagnostic errors

Continuous learning and improvement are essential for reducing diagnostic errors and creating a safer healthcare environment. Key elements of the learning process are identifying the root causes, analysing and measuring the impact, and implementing changes to improve diagnostic processes and prevent future errors.

Providing ongoing training and education for healthcare professionals on diagnostic reasoning, error prevention, and safety protocols are also a core part of continuous quality improvement.

NHS England offers training on clinical risk management and digital safety standards. This provides healthcare professionals (and manufacturers like us) with an understanding of key clinical risk management processes, activities and documentation that are required to be compliant with the DCB0129 and DCB0160 standards.

Improving clinical safety for better outcomes

Ensuring clinical safety in diagnostics requires a multilayered approach that combines improved processes including greater access to diagnostics and data, better communication and teamwork, and continuous learning.

True progress will only be achieved through a culture of collaboration, where clinicians, policymakers, and patients work together to drive improvements in diagnostic processes.

By continuing to invest in digital infrastructure, fostering a culture of safety, and prioritising education and training, we can move towards a healthcare system where diagnostic accuracy is maximised, delays are minimised, and patient outcomes are continually improved.

[1] National Academies of Sciences, Engineering, and Medicine, Improving diagnosis in health care. Washington, DC: The National Academies Press, 2015.