AHRQ Improving Diagnostic Safety in Ambulatory Care: Strategies and Preventions (R18) | RFA HS 23 011

Opportunity Information: Apply for RFA HS 23 011

The AHRQ Improving Diagnostic Safety in Ambulatory Care: Strategies and Preventions (R18) grant opportunity (Funding Opportunity Number RFA-HS-23-011) is a discretionary grant program from the Agency for Health Care Research and Quality (AHRQ) focused on strengthening diagnostic safety and diagnostic quality in ambulatory care settings. The central aim is to support projects that improve how diagnoses are made, communicated, followed up, and corrected in the real-world outpatient environment, which is often highly variable across practices, patient populations, staffing models, and technology capacity. Through this announcement, AHRQ is inviting proposals that not only examine where and why diagnostic breakdowns happen in outpatient care, but also develop, test, and rigorously evaluate practical primary care activities that can reduce diagnostic errors and prevent harm.

A key theme of the opportunity is the complexity and heterogeneity of ambulatory care. Unlike a single hospital unit with standardized workflows, outpatient care includes a wide range of settings such as independent primary care practices, community health centers, academic outpatient clinics, urgent care centers, and other office-based environments where diagnostic work is distributed over time. Diagnosis in these settings frequently depends on longitudinal information, incomplete data at the point of care, coordination among multiple clinicians and services, and reliable systems for test ordering, test result tracking, referrals, and follow-up. As a result, projects responsive to this funding opportunity are expected to address the everyday realities of outpatient diagnostic processes, including gaps that occur between visits, across organizations, or within electronic health record and communication workflows.

The funding mechanism is an R18, which generally emphasizes research and demonstration projects that develop and evaluate interventions with real-world applicability. In practice, that means AHRQ is looking for proposals that move beyond describing the problem and instead produce evidence on strategies that can be implemented in primary care or broader ambulatory contexts. Competitive projects under this kind of mechanism typically focus on designing an intervention (for example, a workflow change, decision support tool, team-based diagnostic process, patient engagement strategy, or safety measurement approach), piloting it in operational settings, and evaluating outcomes in a way that shows whether it improves diagnostic safety and quality. The announcement specifically signals interest in primary care activities, suggesting that proposals should be grounded in outpatient clinical operations and designed for adoption in routine care, not just controlled research environments.

Basic administrative details include that the activity category is Health and the CFDA (Assistance Listing) number is 93.226. The posted award ceiling is $500,000, indicating the maximum anticipated award amount per project under the announcement. The original closing date listed for applications was April 19, 2023, and the opportunity was created on February 13, 2023. (Applicants should always confirm current status and any updates or re-issues of the opportunity when planning submissions, since timelines and availability can change across cycles.)

Eligibility for this opportunity is broad and includes a wide range of public and private entities. Eligible applicants include state, county, city or township governments, special district governments, and independent school districts, as well as public and state-controlled institutions of higher education and private institutions of higher education. Tribal eligibility includes Native American tribal governments that are federally recognized and Native American tribal organizations other than federally recognized tribal governments. The opportunity is also open to public housing authorities/Indian housing authorities, nonprofit organizations with 501(c)(3) status, nonprofits without 501(c)(3) status (in both cases, other than institutions of higher education), for-profit organizations other than small businesses, and small businesses. AHRQ also explicitly highlights additional eligible applicant types such as Alaska Native and Native Hawaiian Serving Institutions; Asian American, Native American, and Pacific Islander Serving Institutions (AANAPISIs); Hispanic-serving institutions; Historically Black Colleges and Universities (HBCUs); Tribally Controlled Colleges and Universities (TCCUs); faith-based or community-based organizations; eligible agencies of the federal government; regional organizations; and U.S. territories or possessions. At the same time, the notice clearly states that non-domestic (non-U.S.) entities (foreign organizations and foreign institutions) are not eligible to apply, and non-domestic components of U.S. organizations are also not eligible, which effectively limits applicant organizations and project components to domestic U.S. operations.

Overall, the opportunity is designed to push the field toward actionable solutions that make outpatient diagnosis safer. The emphasis on development, testing, and evaluation signals that AHRQ is seeking interventions that can be measured, refined, and demonstrated to improve diagnostic processes in everyday ambulatory care, ultimately reducing missed or delayed diagnoses and improving the reliability of follow-up and care coordination where outpatient diagnostic harm often occurs.

• The Agency for Health Care Research and Quality in the health sector is offering a public funding opportunity titled "AHRQ Improving Diagnostic Safety in Ambulatory Care: Strategies and Preventions (R18)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.226.
• This funding opportunity was created on 2023-02-13.
• Applicants must submit their applications by 2023-04-19. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $500,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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