AHRQ Understanding and Improving Diagnostic Safety in Ambulatory Care: Incidence and Contributing Factors (R01) | PA 23 291

FAQs: AHRQ Understanding and Improving Diagnostic Safety in Ambulatory Care: Incidence and Contributing Factors (R01) (PA 23-291)

What is this funding opportunity?

This is an AHRQ discretionary grant program supporting health services research to strengthen diagnostic safety in ambulatory (outpatient) care. The focus is on generating practical, evidence-based knowledge about how often diagnostic errors happen in outpatient settings and why they happen.

What is the core goal of the program?

The core goal is to measure the incidence (how often) diagnostic errors occur in ambulatory care and identify contributing factors that lead to missed, delayed, or incorrect diagnoses in real-world outpatient care, including how these rates and drivers vary across different ambulatory environments.

What does AHRQ mean by "diagnostic safety" in this announcement?

Within the scope of the information provided, diagnostic safety refers to preventing and understanding diagnostic breakdowns that result in missed, delayed, or incorrect diagnoses in outpatient care. The program emphasizes studying the diagnostic process and the factors that contribute to errors.

What settings count as "ambulatory care" for this opportunity?

Ambulatory care is described as a broad and heterogeneous landscape that can include primary care practices, specialty clinics, urgent care, retail clinics, community health centers, and other outpatient service models where patients may move between clinicians, sites, and systems.

Why does the opportunity emphasize variation across ambulatory environments?

The announcement highlights that ambulatory care is diverse, with different workflows, care models, and transitions across sites and clinicians. Studies are expected to help explain how diagnostic error incidence and contributing factors differ across these outpatient contexts.

What types of research questions fit this announcement?

Projects are expected to (1) estimate measurable rates of diagnostic error in outpatient settings and (2) identify and characterize the contributing factors that drive diagnostic breakdowns. The intent is to build a foundation for improving diagnostic safety by producing actionable insights that can inform interventions, policy, or quality improvement strategies.

What is meant by examining the diagnostic process "end-to-end"?

End-to-end diagnostic process examination can include patient presentation, history-taking, testing, follow-up, referrals, communication of results, and care transitions. The aim is to locate where breakdowns occur across the full outpatient diagnostic workflow.

What kinds of contributing factors are of interest?

The announcement indicates interest in surfacing system factors, clinician factors, patient factors, and technology factors that contribute to diagnostic breakdowns in ambulatory care.

Is the program only interested in describing problems, or also in solutions?

The emphasis is not only on describing diagnostic safety problems, but on building a stronger foundation for improving diagnostic safety. Applications are expected to produce actionable insights, measurable rates, and clearly characterized drivers of error that could inform interventions, policy, or quality improvement strategies.

What is the funding mechanism?

The mechanism is an R01 research project grant under the health funding activity category. The opportunity is identified as PA 23-291.

What is the CFDA number for this opportunity?

The CFDA number listed is 93.226.

What is the maximum (ceiling) award amount?

The listed award ceiling is $500,000.

How many awards will be made?

The expected number of awards is not specified in the information provided.

What is the application timeline for this opportunity?

The opportunity shows a creation date of 2023-08-22 and an original closing date of 2028-07-06, indicating a long application window and ongoing programmatic interest.

Who is eligible to apply?

Eligibility is broad and includes many types of domestic public and private entities. Eligible applicants include state, county, city or township, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; public housing authorities/Indian housing authorities; Native American tribal organizations other than federally recognized tribal governments; nonprofit organizations with or without 501(c)(3) status (excluding institutions of higher education within those nonprofit categories); and other unspecified eligible entities.

Are certain institution types explicitly called out as included?

Yes. The announcement explicitly includes categories often highlighted in federal opportunities, such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, regional organizations, and eligible federal government agencies.

Are U.S. territories or possessions eligible to apply?

No. U.S. territories or possessions are not eligible to apply based on the information provided.

Are non-U.S. (foreign) entities or non-domestic components eligible?

The information provided notes "non-domestic (non-U.S.) entities (foreign organizations)" in the other-eligible-applicants language, but it also explicitly states that non-domestic (non-U.S.) components of U.S. organizations are not eligible to apply. Because of this tension, applicants are advised (based on the provided text) to pay close attention to the full official funding announcement and applicable NIH/AHRQ policy language to confirm eligibility and where proposed work can occur.

What kinds of project scope does an R01 suggest for this opportunity?

The R01 format is described as suited for substantial research efforts that may involve multi-site data, rigorous measurement strategies, mixed methods, or advanced analytics to estimate incidence and identify contributory factors in ambulatory diagnostic safety.

Does the opportunity focus on outpatient care only?

Yes. The opportunity is aimed at diagnostic safety in ambulatory (outpatient) care, where a large share of healthcare occurs.

What would a competitive proposal likely demonstrate?

Based on the information provided, competitive proposals will likely be those that can credibly quantify diagnostic error incidence in ambulatory settings, explain the underlying contributory factors across workflows and contexts, and produce findings that are transferable across different outpatient environments.

What kinds of outpatient workflows and transitions are relevant?

The announcement highlights outpatient models where patients move between clinicians, sites, and systems, and encourages examination of diagnostic steps such as testing, follow-up, referrals, results communication, and care transitions.

What is AHRQ looking for in terms of outputs and usefulness?

AHRQ is signaling interest in research that yields practical, evidence-based and actionable findings: measurable error rates, clearly described contributing factors, and insights that can inform interventions, policy decisions, or quality improvement strategies in real-world ambulatory care.