Declaring Uncertainty: Using Quality Improvement Methods to Change the Conversation of Diagnosis

^aDivisions of Hospital Medicine,
^cEmergency Medicine, and
^fBiomedical Informatics and
^dDepartments of Patient Services and
^gInformation Services, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
^bDepartment of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
^eNortheast Node, National Drug Abuse Treatment Clinical Trials Network, Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire

Address correspondence to Anna J. Ipsaro, MD, MBE, Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 3024, Cincinnati, OH 45229. E-mail: anna.ipsaro{at}cchmc.org

Dr Ipsaro conceptualized, designed, and executed the study, coordinated the quality improvement team, designed the data collection instruments, gathered data, conducted the data analysis, and reviewed and revised the manuscript; Dr Patel, Mrs Rohrmeier, Ms Luksic, and Ms Bell participated in design and execution of the study, collected data, conducted the data analysis, and reviewed and revised the manuscript; Dr Warner participated in execution of the study, collected data, conducted the data analysis, and reviewed and revised the manuscript; Dr Marshall conducted the data analysis and reviewed and revised the manuscript; Mrs Richardson coordinated the quality improvement team, designed the data collection instruments, gathered data, conducted the data analysis, and reviewed and revised the manuscript; Mrs Kammer supervised the quality improvement team, participated in design and execution of the study, collected data, conducted the data analysis, and reviewed and revised the manuscript; Dr Hagedorn conceptualized and designed the study, supervised the quality improvement team, conducted the data analysis, drafted the initial manuscript, and reviewed and revised the manuscript; Dr Chan participated in design and execution of the study, collected data, conducted the data analysis, and reviewed and revised the initial submission of this manuscript before his passing; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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