The Society to Improve Diagnosis in Medicine (SIDM), the Jefferson Center, and the Maxwell School of Citizenship and Public Affairs at Syracuse University are working with healthcare consumers to develop a list of the ways patients can reduce diagnostic error. The project is using a process developed by the Jefferson Center’s founder, Ned Crosby, PhD, to provide informed deliberation and recommendations for action on specific social issues. The centerpiece of the process is its “citizen juries.”
Citizen juries are groups of between 20 and 100 people recruited randomly and selected to reflect local population demographics. A daily stipend and support for child care and other expenses help remove financial hardship as a barrier to participation. Jury members meet in person for a few days to learn and deliberate about a specific topic. At the end of the meeting, they issue recommendations.
The project on diagnostic error is part of a two-year study funded by the Agency for Healthcare Research and Quality and has two research interests: 1) assessing the quality of the deliberative process and 2) discovering practical methods for reducing diagnostic error through patient engagement.
To develop a citizen jury for diagnostic error, the Jefferson Center’s executive director, Kyle Bozentko, and associate director, Larry Pennings, worked with Tina Nabatchi, associate professor at the Maxwell School, and mailed recruitment materials to nearly 15,000 households in central New York state’s Onondaga County. With additional digital outreach and advertising, they were able to select enough individuals for citizen jury meetings held over two three-day periods.
The first panel, numbering approximately 50 people, met at Syracuse University in August 2015. The initial session included a half-day of presentations by SIDM representatives Paul Epner and Kathy McDonald. Half of the panel had been enlisted for this education-only part of the program and were finished after completing pre- and post-surveys. The remaining participants—the citizen jury—stayed for two-and-a-half days of further presentations, which included Helen Haskell and Peggy Zuckerman, members of SIDM’s Patient Engagement Committee.
Following facilitated discussion, the jury made preliminary identification of improvement actions. In November, the same 25 people came together again for a similar three-day program. At the end of that session, they issued recommendations for actions patients can take to reduce diagnostic error, as well as barriers patients may encounter in the current healthcare system.
In early February 2016, a new group of 100 citizens met in Syracuse for a one-day event. They received some background information about diagnostic error and the earlier deliberations and assessed the citizen jury’s recommendations for relevance and usability. In the coming months, SIDM, the Jefferson Center, and the Maxwell School will issue a final report on the project and the patient recommendations.
More information is available at http://jefferson-center.org/patient-dx.