{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:10:51Z","timestamp":1788779451254,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R18HS029366"],"award-info":[{"award-number":["R18HS029366"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The National Academies' Improving Diagnosis in Health Care report outlined eight goals for improving the diagnostic process and building a culture of diagnostic excellence. Despite a decade passing since these recommendations, development of programs remains inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore diagnostic excellence improvement efforts across hospital medicine divisions in largely academic settings to identify opportunities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used rapid qualitative methods to analyze focus groups with hospitalist clinicians recruited from sites participating in an AHRQ\u2010funded study. After creating focus group summaries and an analytical matrix, thematic analysis was conducted using a mixed inductive and deductive method at the semantic level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven focus groups were conducted with 30 participants across 14 hospitals. Participants described more than 80 interventions, programs, and tools to improve diagnostic processes. Five themes were identified: (1) current diagnostic excellence efforts were weighted toward reactive rather than proactive interventions; (2) successful diagnostic excellence programs need to focus on both systems issues and clinician performance; (3) clinicians desired greater support in the diagnostic process, especially when cognitive load impairs clinical reasoning; (4) clinicians desired a supportive culture for feedback; and (5) for new ideas to succeed, context of care and resource constraints will need to be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our findings highlight limited scope in diagnostic safety efforts, which remain largely centered on retrospective case reviews and conferences. Clinicians desire system\u2010level redesign encompassing improved team dynamics, reduced cognitive load, psychologically safe feedback, and optimization of the electronic health record. This shift is hindered by cultural, leadership, and resource\u2010related barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70453","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:33:19Z","timestamp":1788777199000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From frameworks to the frontline: Hospitalist perspectives on diagnostic excellence programs"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1399-2881","authenticated-orcid":false,"given":"Angela","family":"Keniston","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine University of Colorado School of Medicine Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond M.","family":"Klein","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts USA"},{"name":"Division of Hospital Medicine Maine Medical Center Portland Maine USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tozier","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts USA"},{"name":"Division of Hospital Medicine Maine Medical Center Portland Maine USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Auerbach","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Barish","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly A.","family":"Kantor","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dev","family":"Patel","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5206-8862","authenticated-orcid":false,"given":"Katie","family":"Raffel","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine University of Colorado School of Medicine Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumant","family":"Ranji","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine UCSF at San Francisco General Hospital San Francisco California USA"},{"name":"Division of Clinical Informatics and Digital Transformation, Department of Medicine UCSF San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7072-0781","authenticated-orcid":false,"given":"Jeff","family":"Schnipper","sequence":"additional","affiliation":[{"name":"Hospital Medicine Unit, Division of General Internal Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the ADEPT Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Improving Diagnosis in Health Care","author":"Medicine Io, National Academies of Sciences E, Medicine","year":"2015"},{"issue":"15","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"3965","DOI":"10.1007\/s11606-022-07554-w","article-title":"Creating a learning health system for improving diagnostic safety: pragmatic insights from US health care organizations","volume":"37","author":"Giardina TD","year":"2022","journal-title":"J Gen Intern Med"},{"issue":"8","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1007\/s11606-024-08625-w","article-title":"Exploring clinical lessons learned by experienced hospitalists from diagnostic errors and successes","volume":"39","author":"Kotwal S","year":"2024","journal-title":"J Gen Intern Med"},{"key":"e_1_2_9_5_1","volume-title":"WRLaBJ. 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