Ambulatory Safety Nets: The power of collaboration and co-design (IHI, 29 February 2024)

Summary

Ambulatory safety nets not only safeguard against diagnostic errors, they also encourage collaboration, support health care providers, and break down competitive barriers for the greater good of patient safety.

Content

It is every patient’s nightmare: A delayed cancer diagnosis. Too many people are familiar with the consequences, which can include a prolonged and tougher course of treatment, increased likelihood of recurrence, emotional suffering, and even death.

A delayed cancer diagnosis is also every care provider’s nightmare. Recognising that delays in cancer diagnoses resulting from lapses in communication pose a significant risk to patient safety, an effort known as ambulatory safety nets — a model pioneered by Kaiser Permanente — is underway in Massachusetts to safeguard against these errors.

Based on the Institute for Healthcare Improvement (IHI) Breakthrough Series Collaborative Model, the effort in Massachusetts is funded by CRICO, the company that provides professional liability insurance coverage for Harvard medical institutions and their affiliates. CRICO assembled, facilitated, and continues to assist and guide this ambulatory safety net implementation collaborative, which includes seven organisations across the CRICO network.

The participating teams:

• Create registries for patients who have abnormal colorectal, breast, lung, and prostate screening tests.
• Develop standard workflows to systematically identify those overdue for recommended follow-up.
• Help patients close the loop on their care through support from patient navigators. 

By co-designing with patients and promoting cooperation between participating organisations, the first phase of the implementation collaborative has led to scheduled or completed colonoscopies for more than 1,300 patients who had been lost to follow up and at risk for a delayed colorectal cancer diagnosis.