Organizational Governance for Diagnostic Excellence in Viet Nam: Leadership, Accountability and Practical Implementation

Organizational Governance for Diagnostic Excellence in Viet Nam: Leadership, Accountability and Practical Implementation

A hospital may have a quality management department, established clinical protocols, an incident reporting system, and several committees responsible for patient safety. Yet when a concern arises about diagnostic quality, it may still be unclear who should take responsibility for addressing it across the organization.

A clinical department may identify a problem involving laboratory services. A diagnostic specialist may recognize a concern that requires changes in several clinical departments. Quality and patient safety personnel may have relevant information but lack the authority or specialist expertise needed to coordinate an effective response.

These situations illustrate an important challenge in healthcare governance. Improving diagnosis requires more than competent healthcare professionals and reliable diagnostic services. It also depends on leadership, clear accountability, multidisciplinary collaboration, and organizational arrangements that support sustained improvement.

For healthcare organizations in Viet Nam, diagnostic excellence offers an opportunity to strengthen existing approaches to healthcare quality and patient safety. Turning that opportunity into meaningful action, however, requires careful consideration of institutional responsibilities, professional roles, available resources, and the regulatory environment.

Organizational governance for diagnostic excellence is not about establishing another committee or administrative structure for its own sake. It is about ensuring that diagnostic quality and safety receive appropriate leadership attention, responsibilities are understood, and improvement efforts can be coordinated and sustained.

Why Diagnostic Excellence Requires Organizational Governance

Diagnosis is often associated with the knowledge and clinical judgment of individual healthcare professionals. These capabilities remain essential, but they operate within healthcare systems that influence how information is obtained, how expertise is shared, and how clinical decisions are supported.

In Improving Diagnosis in Health Care (2015), the National Academies of Sciences, Engineering, and Medicine emphasized that diagnosis is a collaborative process shaped by the healthcare environment. The report identified organizational leadership, effective teamwork, supportive work systems, and continuous learning as important conditions for improving diagnostic performance.

The World Health Organization reinforced the importance of both system-related and cognitive factors during World Patient Safety Day 2024, which focused on improving diagnosis for patient safety.

Workload, fragmented information, communication difficulties, limited access to specialist expertise, and ineffective coordination can all affect diagnostic care. Addressing these conditions often requires decisions that individual healthcare professionals cannot make independently.

Healthcare organizations determine how services are organized, which priorities receive resources, how departments work together, and how concerns about quality and safety are addressed. They also influence whether healthcare professionals have opportunities to seek advice, discuss uncertainty, and participate in improvement activities.

Without appropriate organizational oversight, diagnostic improvement may remain fragmented. Individual departments can identify problems and introduce useful changes, but risks involving several services are often more difficult to address when responsibility for coordinating the response is unclear.

A hospital may invest in advanced diagnostic equipment without giving sufficient attention to the expertise and operational arrangements needed to use it effectively. Another organization may strengthen incident reporting without establishing how diagnostic concerns identified through those reports will influence improvement priorities.

These situations do not necessarily indicate a lack of professional commitment. They may reflect a gap between an organization's general commitment to quality and its specific arrangements for governing diagnostic excellence.

Effective governance helps close that gap by connecting clinical expertise, organizational priorities, leadership decisions, and practical improvement activities.

What the CDC's 2026 Framework Means for Healthcare Organizations

On February 4, 2026, the U.S. Centers for Disease Control and Prevention published Core Elements of Hospital Diagnostic Excellence, providing a structured approach to improving diagnosis at the organizational level.

The framework was developed in consultation with the Agency for Healthcare Research and Quality and the Centers for Medicare & Medicaid Services, drawing on expertise from clinical professionals and the patient community.

It identifies six interconnected elements: leadership commitment and accountability; multidisciplinary expertise; patient, family, and caregiver engagement; improvement actions; education; and tracking and reporting.

Together, these elements recognize that diagnostic excellence requires more than isolated clinical interventions. Healthcare organizations need arrangements that allow professional expertise, leadership decisions, and improvement activities to reinforce one another.

The CDC recommends that hospitals establish dedicated diagnostic excellence programs supported by senior leadership and professionals with relevant clinical and diagnostic expertise. Its preferred approach is for these programs to maintain a distinct identity and dedicated focus while coordinating their work with existing quality improvement and patient safety programs.

The framework also recommends an executive sponsor and at least two designated program co-leaders: a generalist physician and an expert in laboratory medicine or radiology. These leaders should receive appropriate time and resources to manage program activities.

This model reflects the collaborative nature of diagnosis, which involves both clinical reasoning and specialized diagnostic knowledge.

The guidance focuses primarily on acute care hospitals in the United States, although its underlying principles may inform improvement in other healthcare settings.

An important distinction is needed when considering its application in Viet Nam.

The CDC framework is an international professional resource. It does not establish a legal requirement for Vietnamese healthcare organizations to create a separate Diagnostic Excellence department, appoint particular professional positions, or adopt the organizational model described in the guidance.

For healthcare organizations in Viet Nam, the framework provides a useful reference for examining whether diagnostic quality and safety receive sufficient attention within existing governance arrangements.

A large hospital may have the resources to establish a dedicated multidisciplinary program. A smaller facility may begin by assigning clear responsibilities and introducing focused improvement activities within its existing quality management system.

Such an adapted approach is not necessarily equivalent to the CDC's preferred stand-alone program model. Nevertheless, it may provide a practical starting point where a dedicated program is not yet feasible.

The central consideration is whether the organization has meaningful accountability, appropriate professional participation, and a workable process for sustaining improvement.

Leadership Commitment Must Be Supported by Action

Leadership commitment can give diagnostic excellence visibility within an organization, but formal endorsement alone is unlikely to change everyday practice.

A statement that diagnostic quality is important has limited value if the professionals responsible for improvement lack sufficient time, access to relevant information, or authority to coordinate activities across departments.

Senior leaders influence whether diagnostic excellence becomes part of the organization's operational priorities. They can help resolve competing demands, allocate resources, encourage cooperation between services, and address barriers that individual departments may be unable to overcome.

For example, an improvement initiative may require contributions from clinical departments, laboratory medicine, information technology, and quality management. Each group may recognize the importance of the work but have other responsibilities competing for attention.

Without leadership support, the initiative may depend largely on individual staff members contributing additional time and effort beyond their established responsibilities.

The CDC's recommendation for an executive sponsor and designated program leaders offers one way to address this challenge.

In Viet Nam, healthcare organizations can consider how comparable responsibilities might be assigned within their existing leadership and professional structures. The arrangement will depend on the facility's organization, clinical services, available personnel, and applicable requirements.

What matters is that responsibilities are explicit and supported by realistic resources.

A designated program leader should understand which activities they are expected to coordinate, which decisions fall within their authority, when higher-level approval is required, and how unresolved concerns can be brought to organizational leadership.

Depending on the facility, the role may require allocated professional time, administrative assistance, access to relevant clinical and operational information, and cooperation from other departments.

Leadership accountability should extend beyond appointing a responsible person. Senior leaders need to understand whether agreed activities are progressing, what barriers remain, and whether significant diagnostic quality and safety concerns are receiving appropriate attention.

Regular review can help maintain that oversight without turning the program into an unnecessarily burdensome reporting exercise.

The value of leadership is demonstrated through decisions and sustained support, not simply through the creation of a committee or approval of a policy document.

Defining Accountability Without Replacing Clinical Judgment

Organizational governance and individual professional responsibility are closely related, but they serve different purposes.

Healthcare organizations have responsibilities for the conditions under which care is provided, including appropriate systems, resources, professional arrangements, and compliance with applicable requirements. Healthcare professionals are responsible for clinical activities and decisions within their authorized scope of practice.

These responsibilities should reinforce one another rather than be treated as interchangeable.

For example, a quality improvement team may identify a recurring diagnostic concern and recommend changes to an organizational process. It should not independently assume responsibility for clinical decisions that require the judgment of appropriately qualified healthcare professionals.

Similarly, assigning responsibility for diagnostic excellence to a hospital quality management department does not transfer the professional obligations of treating physicians, laboratory professionals, or diagnostic specialists to that department.

Nor does the existence of individual professional responsibilities remove the healthcare organization's own duties under applicable law.

Governance should therefore distinguish responsibility for coordinating an improvement program from responsibility for providing clinical care, while recognizing that both contribute to patient safety.

A designated clinical leader may coordinate professional priorities. Laboratory and radiology experts may advise on diagnostic capabilities, test limitations, and clinical interpretation. Quality and patient safety personnel may support risk assessment, implementation, and evaluation.

Information technology personnel may help determine whether existing systems can support the changes being considered.

Each group contributes different expertise, but its role should remain consistent with applicable professional and institutional responsibilities.

These boundaries become particularly important when an improvement initiative affects several departments.

An organization may benefit from documenting the responsibilities of key participants, the authority of program leaders, and the arrangements for escalating decisions that require institutional approval.

Such documentation should clarify how people work together rather than create unnecessary administrative complexity.

Clear accountability should make cooperation easier, not establish competing lines of authority or additional uncertainty about responsibility for clinical decisions.

Multidisciplinary Expertise Strengthens Governance

Diagnostic excellence cannot be governed effectively from a single professional perspective.

Clinical medicine, laboratory medicine, diagnostic imaging, pathology, nursing, quality management, and other healthcare disciplines contribute different forms of expertise.

The professionals involved should reflect the clinical questions and organizational risks being addressed.

A concern involving microbiological diagnosis may require input from treating clinicians, microbiologists, laboratory professionals, infection prevention personnel, and antimicrobial stewardship teams.

An issue involving imaging services may require cooperation between referring clinicians, radiologists, imaging technologists, and relevant quality or information systems personnel.

Other concerns may involve emergency medicine, pathology, outpatient services, nursing, or specialized clinical departments.

The purpose is not to require every department to participate in every discussion. It is to ensure that relevant expertise is available when improvement requires decisions across professional or organizational boundaries.

A multidisciplinary approach can also strengthen the quality of governance decisions.

Different professionals may have legitimate perspectives on the same issue. A clinician may emphasize timely access to an investigation, while a diagnostic specialist may raise concerns about the limitations of the test or the consequences of inappropriate use.

These perspectives do not necessarily conflict. When considered together, they can help the organization identify a more appropriate response.

Effective governance creates opportunities for constructive professional discussion without allowing organizational hierarchy or departmental interests to override relevant clinical evidence and patient safety considerations.

For smaller healthcare facilities, multidisciplinary participation may need to be arranged differently.

A clinic may not employ specialists in every diagnostic discipline. It may instead identify a clinical leader and establish appropriate arrangements for obtaining external professional input when necessary.

The organizational structure can vary, but the principle remains the same: decisions about diagnostic quality should involve the expertise needed to understand their clinical and operational consequences.

Integrating Diagnostic Excellence With Existing Quality Management in Viet Nam

Healthcare organizations in Viet Nam operate within a legal and professional framework that establishes responsibilities for quality management and patient safety.

Hospitals may have quality management councils, quality management departments or teams, professional councils, clinical departments, and established arrangements for medical incident prevention.

Diagnostic excellence should build on these existing responsibilities rather than be developed as an unrelated administrative activity.

Circular No. 19/2013/TT-BYT provides an important framework for managing the quality of medical examination and treatment services in hospitals. It addresses organizational arrangements, leadership responsibilities, continuous improvement, and the participation of healthcare personnel in quality management.

The Circular recognizes patient-centered care and ongoing quality improvement as important principles of hospital management.

These principles are consistent with the broader objectives of diagnostic excellence. However, an established quality management system does not automatically ensure that diagnostic quality and safety receive sufficient dedicated attention.

Diagnostic concerns may involve several specialties, extend across different clinical encounters, or arise from circumstances that are difficult to recognize through routine hospital quality reporting.

An organization may therefore benefit from identifying a specific leadership responsibility or coordinating function for diagnostic excellence.

This does not necessarily require establishing a separate department.

For hospitals with sufficient resources, a dedicated multidisciplinary program may provide the closest alignment with the CDC's recommended approach.

For facilities with more limited capabilities, assigning clearly defined responsibilities within an existing quality and patient safety structure may offer a practical initial arrangement.

Such an approach should still ensure that diagnostic quality receives meaningful attention rather than disappearing among numerous other improvement priorities.

It should also respect the responsibilities already assigned under the facility's legally established organizational structure.

The objective is to strengthen accountability and coordination without duplicating existing functions or introducing conflicting authority.

This distinction matters beyond hospitals.

Other licensed healthcare facilities may operate under different organizational and professional requirements. They should not assume that every provision of a regulation specifically governing hospital quality management applies identically to their setting.

Any proposed governance arrangement must reflect the facility's legal status, authorized services, professional responsibilities, and applicable regulations.

Selecting Priorities According to Risk and Clinical Need

A diagnostic excellence program cannot address every possible concern simultaneously.

Healthcare organizations need to determine which issues warrant attention and where improvement efforts are most likely to provide meaningful value.

Priority setting should consider clinical significance, the potential for patient harm, available evidence, the feasibility of intervention, and the resources required.

Information from existing quality reviews, medical incident reporting, healthcare professionals, patient experiences, and routine operations may help identify concerns deserving further examination.

These sources are useful, but they do not automatically provide a complete or unbiased picture of diagnostic safety.

A concern reported frequently is not necessarily the most serious risk. Equally, an infrequent event may deserve attention if its potential consequences are substantial.

Leadership should also avoid selecting priorities solely because they are easy to measure or likely to produce rapid operational savings.

Some important diagnostic risks involve limited access to expertise, complex clinical decisions, or organizational conditions that are not easily represented by routine numerical indicators.

A risk-based approach should combine available information with professional judgment and an understanding of the clinical context.

For example, an organization may recognize that a diagnostic activity involves several departments but lacks a clear mechanism for resolving disagreements or coordinating improvement. Another facility may identify limited access to specialist diagnostic advice in an area of significant clinical need.

These concerns may justify organizational action even if they do not immediately produce an increase in reported adverse events.

The selected priorities should be sufficiently specific to guide decisions. A broad commitment to improve every aspect of diagnosis may be difficult to translate into a workable plan.

A focused priority can help leadership determine which professionals should participate, what resources are needed, and how progress can reasonably be assessed.

The purpose is to direct organizational effort toward issues that are clinically important and realistically manageable.

Governing Diagnostic Services Across Organizational Boundaries

Diagnostic care often involves relationships between different healthcare organizations and external service providers.

A hospital or clinic may use an external laboratory, an independent imaging facility, a specialist consultation service, or another organization for part of its diagnostic activities.

These arrangements can improve access to expertise and technology, but they may also create challenges involving responsibilities, information availability, communication, and service coordination.

Organizational governance should consider these relationships.

When diagnostic services are provided externally, the organizations involved need to understand their respective responsibilities under applicable laws, professional requirements, and contractual arrangements.

Relevant considerations may include service scope, quality assurance, communication expectations, management of significant concerns, and arrangements for addressing operational difficulties.

The applicable obligations will depend on the type of service and the legal relationship between the organizations.

Using an external provider should not automatically be interpreted as removing every responsibility from the healthcare organization arranging or using the service.

At the same time, an organization cannot necessarily exercise direct control over the clinical and operational activities of another independent provider.

Clear agreements and practical coordination arrangements can help define expectations while respecting those boundaries.

Healthcare systems operating across multiple facilities face related challenges. A common organizational policy may be implemented in facilities with different clinical capabilities, staffing arrangements, diagnostic equipment, and patient populations.

Centralized governance may provide consistency, but it should also allow appropriately justified local adaptation where operational and clinical circumstances differ.

The objective is to reduce unnecessary fragmentation while recognizing the limits of organizational authority and the responsibilities of independent healthcare providers.

Patient Perspectives Should Inform Organizational Decisions

Patients and families are important participants in diagnostic care, but their contribution to organizational improvement is sometimes limited to satisfaction surveys or complaints.

A broader approach recognizes that patients may identify difficulties not readily visible in routine clinical and administrative records.

Their experiences can provide information about access to services, communication, understanding of diagnostic information, and other aspects of care that may influence organizational priorities.

The CDC's 2026 framework identifies patient, family, and caregiver engagement as a core element of diagnostic excellence.

At the governance level, the practical question is how patient perspectives can inform decisions about improvement.

Healthcare organizations may use established feedback mechanisms, appropriately designed consultations, or other engagement arrangements suited to their services and patient populations.

The chosen approach should be accessible and considerate of differences in health literacy, disability, communication needs, and access to healthcare.

Feedback collected only from patients who can participate easily may not adequately represent the experiences of people facing greater barriers.

Patient engagement should complement professional oversight rather than replace it.

Patients should not be expected to assume responsibility for identifying and correcting organizational weaknesses that healthcare providers are required to manage.

The involvement of family members and caregivers must also respect patient rights, confidentiality, applicable consent or representation arrangements, and Vietnamese legal requirements.

Meaningful participation can strengthen governance when patient experiences are considered alongside clinical expertise and other relevant evidence.

Diagnostic Information Systems Require Clinical Oversight

Digital technologies can support diagnostic excellence by improving access to clinical information, facilitating communication, and providing information for organizational improvement.

However, introducing an electronic system does not automatically make diagnostic care safer.

A system may improve the availability of results while creating new difficulties involving fragmented interfaces, inappropriate notifications, incomplete information, or unclear responsibilities.

Healthcare organizations should therefore consider information technology as part of the clinical work system rather than an independent solution.

Clinical and diagnostic professionals need appropriate involvement when systems affecting diagnostic activities are selected, configured, implemented, or substantially modified.

Their participation can help identify how technology may influence clinical decisions and whether new arrangements are practical within existing workflows.

Organizations should also consider system reliability, staff training, information security, and suitable arrangements when technology is unavailable.

Digital tools and automated decision-support functions may offer benefits, but they can introduce risks that are not apparent from technical specifications alone.

Healthcare organizations should assess those risks before implementation and maintain appropriate oversight after systems enter routine use.

Technology providers may contribute important technical expertise, but institutional responsibility for clinical governance cannot simply be transferred to vendors.

Where software provides automated recommendations, additional attention may be needed to its intended use, limitations, professional oversight, and the circumstances in which recommendations may be unreliable.

In Viet Nam, Circular No. 13/2025/TT-BYT provides a relevant regulatory framework for electronic medical record implementation.

Improved electronic information management may support diagnostic quality, particularly when relevant information becomes more accessible to authorized healthcare professionals.

Nevertheless, digitalization and diagnostic excellence remain distinct objectives.

A healthcare organization can operate an advanced information system while still experiencing diagnostic safety concerns. Conversely, a facility with more limited technological capabilities may improve aspects of diagnostic care through clearer responsibilities and better organizational arrangements.

The purpose of technology governance is to ensure that digital systems support clinical work, professional accountability, information security, and patient safety.

Monitoring Progress Without Misinterpreting Performance

Healthcare leaders need information to determine whether diagnostic excellence activities are being implemented and whether they are contributing to improvement.

However, monitoring should not be reduced to counting policies, meetings, training sessions, or completed projects.

Such information may show that a program is active, but it does not necessarily establish that diagnostic care has become safer.

The CDC's 2026 framework includes tracking and reporting as a core element. It also recognizes important limitations in the availability of diagnostic safety measures suitable for comparing hospitals.

Healthcare organizations should therefore select measures that reflect their objectives, available data, and specific improvement activities.

During the early stages of a program, relevant information may include whether responsibilities have been assigned, whether multidisciplinary participation is functioning, and whether agreed improvement activities are progressing.

For more established initiatives, organizations may consider measures related to specific clinical priorities.

The interpretation of these findings should remain proportionate to what the data can demonstrate.

An increase in reported diagnostic safety concerns does not necessarily mean that care has become less safe. Improved awareness or reporting may make previously unrecognized problems more visible.

Likewise, a low number of reported concerns does not establish that diagnostic care is reliable.

Leadership should also consider unintended consequences.

An improvement initiative may address one problem while increasing workload or creating delays elsewhere. A reduction in diagnostic testing may reflect more appropriate utilization, but it could also indicate restricted access to necessary investigations.

These possibilities require balanced evaluation.

Monitoring should help leaders understand whether the program is functioning, where difficulties remain, and what decisions are needed.

It should support organizational learning rather than create unsupported comparisons or simplistic judgments about professional performance.

Creating Conditions for Open Discussion and Learning

Diagnostic improvement depends partly on whether healthcare professionals can raise concerns, discuss uncertainty, and learn from experience.

A work environment in which every diagnostic concern is immediately interpreted as an individual failure may discourage reporting and make organizational weaknesses more difficult to recognize.

The National Academies' Improving Diagnosis in Health Care emphasized the importance of a culture that supports open discussion, feedback, and learning from diagnostic performance.

This does not mean that professional responsibilities should be ignored or that unfavorable outcomes should automatically be regarded as unavoidable.

Organizations need processes that examine concerns fairly, consider relevant clinical and organizational circumstances, and distinguish quality improvement activities from formal professional or legal determinations.

Leadership plays an important role in establishing these expectations.

Healthcare professionals should understand how concerns can be raised, how information will be reviewed, who may access relevant records, and how findings will be used.

Feedback to participating staff is also important. When healthcare professionals see that reporting leads to thoughtful consideration and meaningful improvement, they may be more willing to contribute.

Educational activities should respond to identified needs rather than become the default recommendation after every problem.

Some concerns may require targeted professional development. Others may involve staffing, supervision, access to expertise, or organizational arrangements that cannot be resolved through additional training alone.

An effective learning culture combines openness with appropriate accountability.

Internal improvement processes must also operate alongside mandatory incident reporting, professional review, and other legal obligations where applicable.

A supportive organizational environment should make it easier to understand and address diagnostic risks without creating the impression that responsibilities under Vietnamese law no longer apply.

Practical Implementation in Different Healthcare Settings

The organizational model for diagnostic excellence should reflect the capabilities and responsibilities of each healthcare facility.

A large tertiary hospital may have the professional expertise, information infrastructure, and quality management resources needed to support a formal multidisciplinary program. A smaller hospital or outpatient facility may require a more focused approach.

The CDC's framework recognizes that hospitals differ in their available resources and encourages programs to begin with priority activities suited to their needs and capabilities.

For healthcare organizations in Viet Nam, a useful starting point may be an assessment of existing governance arrangements.

Leadership can examine whether diagnostic quality has a clearly identified organizational owner, whether relevant professionals participate in decisions, and whether concerns can reach the appropriate level for action.

The organization may discover that much of the necessary infrastructure already exists within its quality and patient safety system.

In that situation, the initial task may be to establish more explicit responsibilities and coordination rather than create an entirely new administrative body.

Where resources permit, a dedicated multidisciplinary program may provide a more comprehensive approach and align more closely with the CDC's preferred model.

An adapted organizational arrangement should still have a clear purpose, defined responsibilities, appropriate leadership support, and a process for reviewing progress.

Once these conditions are established, the organization can identify a manageable improvement priority.

The selected concern should be clinically important, supported by sufficient information, and feasible to address with available or reasonably obtainable resources.

A healthcare facility may decide to strengthen coordination between clinical and diagnostic services, improve access to specialist advice, or address an organizational weakness identified through existing quality activities.

Before introducing changes on a larger scale, leadership should consider whether the proposed arrangements are practical and whether the people involved understand their responsibilities.

Small-scale implementation can help identify difficulties that were not apparent during planning.

The organization can then review whether the arrangements are functioning, whether further support is required, and whether the intervention should be modified.

A comprehensive program covering every diagnostic specialty is not necessarily the most appropriate initial step for every facility.

A clearly governed initiative focused on an important clinical concern may provide a foundation for developing broader organizational capabilities over time.

Sustaining Diagnostic Excellence Beyond Individual Projects

One challenge in healthcare improvement is maintaining progress after the initial project has been completed.

An initiative may begin with strong leadership support and active professional participation but receive less attention as organizational priorities change.

Diagnostic excellence requires a longer-term commitment.

Sustainability depends on whether responsibilities remain clear, activities become part of routine operations, and leaders continue to consider relevant risks and improvement needs.

Programs should also be resilient to changes in personnel.

An initiative that depends entirely on one enthusiastic professional may become vulnerable when that person changes roles or leaves the organization.

Healthcare leaders should consider how responsibilities, institutional knowledge, and necessary documentation can be maintained through such transitions.

Resource planning is equally important.

Improvement activities may require ongoing professional time, education, access to information, technical support, or modifications to existing systems.

Organizations should distinguish between resources needed to establish an initiative and those required to sustain it.

Financial considerations are relevant, but the value of diagnostic excellence should not be judged solely by reductions in expenditure.

Some improvements may reduce unnecessary investigations or operational inefficiencies. Others may require greater investment in essential diagnostic capabilities, specialist expertise, or clinical support.

A program driven primarily by cost reduction could create incentives that conflict with patient safety.

Governance should also consider how decisions about purchasing diagnostic equipment, introducing new tests, or expanding services are influenced by clinical evidence, financial expectations, and potential conflicts of interest.

An investigation or diagnostic service should not be adopted or promoted solely because it generates additional revenue when credible evidence of clinical benefit for the intended use is insufficient.

These decisions require appropriate professional assessment and institutional oversight.

Healthcare leaders should consider how clinical, operational, and financial priorities interact while maintaining transparency and compliance with applicable requirements.

Diagnostic excellence is more likely to be sustained when it becomes part of an organization's continuing responsibility for quality and safety rather than a temporary campaign or an activity undertaken only for external assessment.

Legal and Professional Considerations in Viet Nam

Organizational governance for diagnostic excellence must operate within the legal and professional framework governing healthcare services in Viet Nam.

The Law on Medical Examination and Treatment No. 15/2023/QH15 provides important provisions concerning the responsibilities of healthcare facilities, professional practice, patient rights, quality management, and medical incident prevention.

The Law should be read together with applicable amendments, including those reflected in Consolidated Document No. 26/VBHN-VPQH, issued by the Office of the National Assembly on February 26, 2026.

Articles 57 and 58 address quality standards and quality assessment for healthcare facilities. Article 58 includes the responsibility of healthcare facilities to conduct annual quality self-assessments against the applicable basic quality standards and provides for disclosure of quality assessment results according to law.

Article 60 establishes responsibilities of healthcare facilities, including compliance with professional and technical requirements, accountability for healthcare activities within their management responsibilities, provision of necessary conditions for healthcare professionals to perform their work, and quality self-assessment and disclosure as required by law.

Article 71 addresses medical incident prevention through identification, reporting, analysis of causes, and preventive measures.

These provisions provide an important legal foundation for organizational quality and patient safety activities.

Decree No. 96/2023/ND-CP further details relevant aspects of the Law on Medical Examination and Treatment, including matters concerning the operation of healthcare facilities and quality assessment.

For hospitals, Circular No. 19/2013/TT-BYT provides an additional framework for quality management. It addresses organizational arrangements, responsibilities of hospital leadership and healthcare personnel, quality management councils, quality management departments or teams, and continuous improvement activities.

These legal requirements are relevant to the governance of diagnostic quality. However, they do not establish a specific obligation for every healthcare facility to create a separate Diagnostic Excellence program modeled on the CDC's 2026 framework.

Any proposed governance arrangement must remain consistent with the facility's legally established organization, authorized professional scope, applicable requirements, and institutional responsibilities.

International recommendations developed by CDC, WHO, the National Academies, and other organizations may inform improvement, but they do not replace Vietnamese legislation or Ministry of Health regulations.

It is also important to distinguish organizational diagnostic improvement from external quality assessment, accreditation, or certification.

A healthcare organization can undertake diagnostic improvement activities without seeking external certification. Conversely, holding an accreditation or certification does not, by itself, establish that every diagnostic safety risk has been identified or adequately controlled.

The management of clinical and organizational improvement information requires additional attention.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/ND-CP, both effective January 1, 2026, form part of the applicable legal framework governing personal data processing, including health-related information.

Healthcare organizations using patient-level information for diagnostic quality reviews, risk management, or other improvement activities should assess the relevant legal basis, purposes of processing, access permissions, security safeguards, retention requirements, and other applicable obligations.

Using aggregated or appropriately de-identified information may reduce privacy risks, but it does not automatically eliminate legal obligations where individuals remain identifiable or re-identification remains reasonably possible.

Additional ethical or regulatory requirements may apply to research activities, external sharing of information, or publication of patient-related data.

Internal quality improvement documents should not be assumed to have automatic legal protection from disclosure or to remove obligations concerning medical incident reporting and professional accountability.

Organizational governance should support learning and patient safety while remaining consistent with applicable Vietnamese law.

Making Diagnostic Excellence an Organizational Responsibility

Improving diagnosis requires more than the efforts of individual healthcare professionals.

Clinical competence, diagnostic expertise, and professional judgment remain essential. However, healthcare organizations shape the conditions in which those capabilities are used.

Leadership decisions influence access to resources, specialist expertise, multidisciplinary collaboration, professional development, information systems, and opportunities for organizational learning.

Governance connects these responsibilities to practical decisions and improvement activities.

The CDC's 2026 framework provides a structured reference for establishing dedicated diagnostic excellence programs. The work of the National Academies and WHO offers broader foundations for understanding diagnosis as a complex process influenced by healthcare systems, professional interactions, and organizational conditions.

For Viet Nam, the opportunity is to adapt these principles to different healthcare settings without assuming that one organizational model will be appropriate for every facility.

The starting point may be relatively modest: clear leadership commitment, designated responsibilities, relevant professional expertise, and a manageable improvement priority.

What matters is whether the organization can explain who coordinates diagnostic excellence, how priorities are determined, how professional expertise contributes to decisions, and how leadership responds when improvement activities encounter difficulties.

These are fundamental questions of organizational accountability.

Diagnostic excellence becomes an organizational responsibility when leadership commitment is translated into clear accountability, meaningful multidisciplinary collaboration, evidence-informed decisions, and sustained improvement in everyday healthcare operations.

Strengthening these capabilities can help healthcare organizations in Viet Nam move beyond isolated improvement initiatives toward a more coordinated and dependable approach to diagnostic quality, safety, and reliability.

Evidence and Policy Context

This article draws on international evidence and professional guidance, including the National Academies of Sciences, Engineering, and Medicine's Improving Diagnosis in Health Care (2015); the World Health Organization's World Patient Safety Day 2024 materials on improving diagnosis for patient safety; and the U.S. Centers for Disease Control and Prevention's Core Elements of Hospital Diagnostic Excellence (2026).

The CDC framework addresses leadership commitment and accountability, multidisciplinary expertise, patient, family, and caregiver engagement, improvement actions, education, and tracking and reporting. Its recommendations were developed primarily for diagnostic excellence programs in acute care hospitals in the United States and should be adapted appropriately when considered in other healthcare settings.

The article also draws on evidence-informed principles of healthcare governance, quality management, professional collaboration, organizational risk management, implementation, and continuous improvement.

The Vietnamese legal context includes the Law on Medical Examination and Treatment No. 15/2023/QH15, as amended and reflected in Consolidated Document No. 26/VBHN-VPQH (2026); Decree No. 96/2023/ND-CP; Circular No. 19/2013/TT-BYT on hospital quality management; Circular No. 13/2025/TT-BYT on electronic medical records; the Law on Personal Data Protection No. 91/2025/QH15; and Decree No. 356/2025/ND-CP.

International diagnostic excellence frameworks are presented as sources of evidence-informed improvement principles. They should not be interpreted as mandatory Vietnamese organizational structures, accreditation requirements, or substitutes for applicable laws, professional standards, and institutional responsibilities.

Professional Scope and Disclaimer

This article is published by Diagnostic Excellence Vietnam (DxEx.vn) for professional education, knowledge-sharing, and general information. It examines organizational governance for diagnostic excellence from the perspectives of healthcare quality, patient safety, leadership accountability, risk management, multidisciplinary collaboration, and evidence-informed implementation.

The content does not constitute individualized medical advice, clinical diagnosis, treatment recommendations, legal advice, an assessment of professional competence, or a legally binding interpretation of Vietnamese regulations. Diagnostic Excellence Vietnam (DxEx.vn) is not a healthcare provider, regulatory authority, or accreditation or certification body.

Clinical decisions, institutional governance, quality improvement activities, medical incident reporting, personal data processing, and organizational implementation remain the responsibility of appropriately qualified professionals and authorized healthcare organizations, subject to applicable Vietnamese laws, professional standards, institutional requirements, and individual patient circumstances.