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AHRQ Improving Diagnostic Safety in Ambulatory Care: Strategies and Interventions (R18)




August 22, 2023



August 31, 2028



Award Floor:



Match Required?





Entity Types:

State governments, County governments, City or township governments, Special district governments, Independent school districts, Public & State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities, Native American tribal organizations, Nonprofits (with 501(c)(3) status), Nonprofits (without 501(c)(3) status)

Other Eligible Applicants include the following: Alaska Native and Native Hawaiian Serving Institutions; Asian American Native American Pacific Islander Serving Institutions (AANAPISISs); Eligible Agencies of the Federal Government; Faith-based or Community-based Organizations; Hispanic-serving Institutions; Historically Black Colleges and Universities (HBCUs); Indian/Native American Tribal Governments (Other than Federally Recognized); Non-domestic (non-U.S.) Entities (Foreign Organizations); Regional Organizations; Tribally Controlled Colleges and Universities (TCCUs) ; U.S. Territory or Possession; Non-domestic (non-U.S.) Entities (Foreign Institutions) are not eligible to apply. Non-domestic (non-U.S.) components of U.S. Organizations are not eligible to apply.




Source Type:


The purpose of this funding announcement is to invite proposals focused on developing strategies and interventions to improve diagnostic safety in the heterogenous ambulatory care environment. AHRQ is interested in providing support designed to develop, test, and evaluate ambulatory care activities that will improve diagnostic safety and quality. The purpose of this R18 NOFO is to invite applications focused on strategies and interventions to improve diagnostic safety and quality in ambulatory care. For the purpose of this NOFO, ambulatory care is defined as medical services performed on an outpatient basis, without admission to a hospital or other facility.

In diagnostic safety, a demonstration project may be conducted to show: 1) the effectiveness and/or impact of an existing or new process, such as requiring a second opinion on all new patients prior to finalizing a diagnosis or increasing the ability to make an accurate diagnosis in people with multiple pre-existing conditions and/or atypical presentations (i.e., method demonstration) or 2) the effectiveness and/or impact of an application, such as a new computer algorithm to improve diagnostic accuracy (i.e., result demonstration) or reducing diagnostic errors associated with care fragmentation. Dissemination is the targeted distribution of information and materials about an evidence-based intervention to a specific clinical practice or public health audience. Dissemination is most effective when it starts early, galvanizes support, uses champions and brokers, considers contextual factors, is timely, relevant, and accessible, and understands the players and processes. This AHRQ R18 NOFO supports projects that mitigate risks, errors, and harms through the design, implementation, and evaluation of patient safety strategies and the adaptation, refinement, and sustainment of those strategies.

Ambulatory care settings are highly diverse in provider types, services, and patient populations, which has changed the scope of clinical practice. Ambulatory care now includes mobile care, retail clinics, urgent care, free-standing emergency departments, high tech centers, the internet, computers, smart phones and convenient care. Providers in these practices have different expectations, skills sets, and knowledge bases regarding diagnostic safety, compared to hospital-based providers. Applicants are encouraged to put in place a team with unique investigator skills outside of traditional hospital medical fields that will contribute to the research in diagnostic safety.

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