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Department of Medicine

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  8. Policy & Practice Improvements

Policy and Practice Impacts

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Policy and Practice Impacts

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The innovations generated by the Safer Dx team have impacted policy and practices at both the VA and other healthcare organizations.

VHA Directive 1088: Communicating Test Results to Providers and Patients

Dr. Singh co-led and worked with the Office of Primary Care on revising on communication of test results which requires VA providers to communicate normal test results to patients within 14 days after the result becomes available or within 7 days when results require follow-up action. This national policy released in July 2023 sets standards related to the timeliness of test results communication and informs a performance measurement and quality improvement program implemented across the entire VA healthcare system. This directive was informed by the Safer Dx team鈥檚 work on missed test results.

Computerized Patient Record System (CPRS) View Alert Notification Checklist

The Safer Dx team created this checklist for the VA to help clinicians and staff manage alerts in the EHR system. It was disseminated to all VISN directors and Chief Medical Officers in 2017. 

10 Strategies for Managing Notifications

This training document was created by the Safer Dx team and distributed to all VA facilities for CPRS training.

National and International Reports

The Safer Dx team鈥檚 work has informed:

  • The American Medical Association (AMA) report Research in Ambulatory Patient Safety 2000-2010: A 10-Year Review (2011) was informed by 9 Safer Dx publications.
  • The Institute of Medicine report Health IT and Patient Safety: Building Safer Systems for Better Care cited 4 publications from the team.
  • The National Academies of Sciences, Engineering, and Medicine (NASEM, formerly the Institute of Medicine) report (2015) cited 33 publications from the team.
  • The National Health Service (NHS) guidelines (2016) cited 1 publication from the Safer Dx team.
  • The World Health Organization (WHO) report (2016) was co-authored by Dr. Singh and cited 11 publications from the team.
  • The ECRI and Partnership for Health IT Patient Safety report (2018) cited 13 publications from the team.
  • The Organization for Economic Co-operation and Development (OECD) report (2018) cited 4 Safer Dx publications.
  • The WHO report (2019) was informed by 2 publications from the Safer Dx team.
  • The National Quality Forum (NQF) report (2020) cited 10 publications from the team.
  • The National Academy of Medicine (NAM) special report (2021) cited 1 publication from the Safer Dx team.
  • NASEM proceedings (2021) cited 1 publication from the team.
  • The NAM report (2021) was informed by 1 Safer Dx publication.
  • The Joint Commission鈥檚 Sentinel Event Alert (2022) cited 2 publications from the team.
  • The WHO report (2022) was co-authored by Dr. Singh and cited 9 publications from the team.
  • The AMA publication (2022) cited 1 publication from the Safer Dx team.
  • The NASEM report (2023) cited 2 Safer Dx publications. 
  • The NAM report (2023) was informed by 1 publication from the Safer Dx team.
  • The WHO (2024) was informed by 7 publications from the team and Dr. Singh contributed a featured story.
  • Dr. Singh was invited to serve on the WHO Drafting and Review Task Force for the Global Patient Safety Action Plan 2021-2030. 
  • Dr. Singh was invited to serve on the WHO World Patient Safety Day 2024 Steering Committee and the Planning Group. 
  • The President鈥檚 Council of Advisors on Science and Technology released its finding on patient safety in a report to President Joe Biden entitled 鈥溾 that cited 2 publications from the Safer Dx team (PMID and PMID ). The report outlines recommendations to advance the nation's commitment to supporting robust safety solutions for patients and the healthcare workforce.