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Safety of patients within health care systems is of paramount importance for us all and is a priority area of analysis for the HCQI team. The HCQI expert group on patient safety tried and tested a set of comprehensive and cohesive indicators for the analysis of five key areas:
• hospital-acquired infections;
• operative and postoperative complications;
• sentinel events;
• obstetrics;
• adverse events
A comprehensive Technical Manual was developed in 2008 to support the calculation of 15 patient safety indicators to be collected in national hospital administrative databases. For each of the indicators, the manual provides detailed definitions of the indicators, coding and calculation processes, as well as a conversion from ICD 9 to ICD 10 coding. A total of 21 countries have participated in three years of data collection, indicator development and methodology testing (2007-2009).
The Patient Safety Indicators Report (2009) outlines the progress of research and development on the indicators and includes an updated and revised Technical Manual (2009). While coding and reporting from administrative hospital databases remains inconsistant, the rigour with which the indicator work has been undertaken has made it easier for countries to report on the quality of care.
This work on the development of the patient safety indicators highlights the technical progress made in constructing measures and the need for methodological improvements.
Ongoing work for 2010-11 includes further analysis of certain countries to validate the methodological approach for the calculation of these indicators. Furthermore, future delelopment work is required to explain why certain algorhythm steps lead to inaccurate variation across countries in the indicators. This is aimed to reinforce the accuracy of the calculation process and ensure more confidence in the Patient Safety indicators for future analysis. Further data is currently being collected from participating countries in order to undertake this development work.
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