Armstrong Institute Opens the First Center for Diagnostic Excellence in the World

Dear Colleagues,

Diagnostic errors, affecting an estimated 12 million Americans each year, will likely touch each of us in our lifetimes. Although missed, delayed and wrong diagnoses are difficult to identify and often go unrecognized, they are likely the most common, catastrophic and costly of all medical errors. Studies suggest they may result in serious permanent harms or death up to one-third of the time. Until recently, patient safety and quality movements have largely ignored this major public health issue.

In an era of value-oriented health care, the problem of missed diagnosis cannot be addressed simply by ordering more diagnostic tests. The costs of advanced diagnostic tests are increasing at a faster rate than any component of health care, driven in part by inappropriate test use. The interrelated problems of diagnostic error and diagnostic test overuse are global problems requiring bold, innovative solutions.

To that end, we are pleased to announce the creation of the Armstrong Institute Center for Diagnostic Excellence. Led by Dr. David Newman-Toker, an internationally recognized leader in diagnostic research and diagnostic safety, the center will enhance diagnostic accuracy, increase diagnostic value and move the needle on eliminating preventable harms from diagnostic errors worldwide.

The first of its kind in the world, the center was made possible by a $5 million gift from C. Michael Armstrong, whose generosity also funded the Johns Hopkins Armstrong Institute for Patient Safety and Quality more than five years ago. As with many of us, this issue has personal relevance to Mr. Armstrong, who himself was the victim of a harmful misdiagnosis.

The center's mission is to innovate to achieve diagnostic excellence and accountability for Johns Hopkins, the region and the world by:

• Eliminating preventable harms from diagnostic errors
• Optimizing patient outcomes and experience in diagnosis
• Reducing waste in diagnostic assessment

Our multidisciplinary core teams include physicians, nurses, allied health professionals, scientists and staff members from the East Baltimore and Johns Hopkins Bayview Medical Center campuses. Together, we have expertise in diagnostic research methods, systems engineering, cognitive psychology, implementation science, patient-centered communication, education, informatics, biostatistics and health economics.

We envision a world where diagnoses are accurate, timely and effectively communicated to patients, avoiding both diagnostic error and overdiagnosis. We see a future in which diagnostic processes are patient-centered, evidence-based, prompt, efficient, safe and equitable.

We will facilitate and focus existing efforts across Johns Hopkins Medicine on improving diagnosis. Our first signature initiative will be to prevent stroke misdiagnosis throughout Johns Hopkins Health System emergency departments. Our goal is to reduce harms from missed strokes by 50 percent in five years.

To learn more about the Armstrong Institute Center for Diagnostic Excellence, read this article, watch this video or visit our website.

Sincerely,

David Newman-Toker, M.D., Ph.D.
Director, Armstrong Institute Center for Diagnostic Excellence
Director, Division of Neuro-Visual and Vestibular Disorders
Johns Hopkins Medicine

Peter J. Pronovost, M.D., Ph.D.
Director, Armstrong Institute for Patient Safety and Quality
Senior Vice President, Patient Safety and Quality
Johns Hopkins Medicine