The Agency for Healthcare Research and Quality (AHRQ), through the Department of Health and Human Services, has issued a funding opportunity under Notice of Funding Opportunity (NOFO) PA-23-290, titled "AHRQ Improving Diagnostic Safety in Ambulatory Care: Strategies and Interventions (R18)." This opportunity seeks to support research projects that develop, test, and evaluate strategies and interventions aimed at improving diagnostic safety and quality in the ambulatory care setting. This NOFO is part of AHRQ’s mission to make healthcare safer, higher quality, more accessible, equitable, and affordable. It is an R18 research demonstration and dissemination grant, which allows for the testing and implementation of practical, real-world solutions to healthcare challenges.

The grant focuses specifically on diagnostic safety within ambulatory care, which refers to medical services performed on an outpatient basis without hospital admission. Research may target process improvements, applications like decision-support tools or algorithms, and education or training initiatives that contribute to accurate, timely diagnoses. The scope of eligible topics aligns with the six research areas identified by the National Academies of Sciences, Engineering, and Medicine (NASEM): error identification and reduction, patient engagement, provider education, health IT, work system improvements, and the external environment. AHRQ particularly encourages studies addressing disparities in diagnostic accuracy related to age, race, ethnicity, gender, and other factors.

Applicants may propose demonstration projects showing the effectiveness of an intervention or application in reducing diagnostic errors and improving health outcomes. Example focus areas include using diagnostic checklists, enhancing education through logic-based models, applying noise-reduction algorithms, or structuring diagnostic teams for collaborative decision-making. Applications must demonstrate how proposed interventions will reduce errors and inequities while considering factors unique to the ambulatory care setting, such as diversity in provider types and fragmented care systems.

Eligible applicants include higher education institutions, local and state governments, nonprofits, tribal governments and organizations, independent school districts, and public housing authorities. For-profit organizations and foreign institutions may participate as subcontractors but cannot serve as lead applicants. The funding cap is $500,000 per year, not to exceed $2 million for a four-year project period. Matching is not required but institutional support is encouraged and can be detailed in the budget justification section.

Applicants must submit through Grants.gov using the SF424 (R&R) application package and follow all AHRQ-specific guidance outlined in the NOFO, which may differ from NIH general instructions. Submissions must comply with human subject protection protocols and include a data management plan. Review criteria include scientific merit, relevance to AHRQ priorities, potential for reducing diagnostic errors and disparities, innovation, and team qualifications. AHRQ expects award announcements approximately eight months after submission deadlines.

Applications follow standard NIH due dates, with the first deadline having been January 25, 2024. The NOFO remains open for submissions until May 26, 2028. While there are no specific letter of intent requirements or advisory council reviews, applicants are encouraged to apply early and ensure all registration steps with SAM, eRA Commons, and Grants.gov are completed in advance.