Investigating selected patient safety indicators using medical records data

Medical errors in hospitals kill more people every year than AIDS, breast cancer and auto accidents combined. Widespread consensus exists that health care organizations can reduce patient injuries by improving the environment for safety from implementing different alternatives from technical and managerial improvements to considering medical record data. Considering the preventability of medical errors, the Agency for Healthcare Quality and Research (AHRQ) developed patient safety indicators (PSIs). This study analyzes the PSIs calculated in Alzahra Hospital of Isfahan.

This study was conducted retrospectively using the inpatient medical record data of hospitalized patients in a six month period, from October 2010 to March 2011. An experienced team in the fields of medical record, health management and health information technology was involved in data reviewing. Based on a prior consultation and reviewing, some PSIs were selected. Indicators were calculated considering AHRQ guidelines. Excel software and hospital information system software were used.

Across all studied medical records of patients, out of 25,164 discharges, below measures were calculated.
-8 Foreign Body cases (PSI 5) (0.31 per 1000).
- 30 Postoperative Hemorrhage or Hematoma cases (PS I9) (2.2 per 1000).
-5 Accidental Puncture or Laceration cases (PSI 15) (0.3 per1000).
- 8 Complications of Anesthesia cases (PSI 1) (2.2 per 1000).
-96 Selected Infections Due to Medical Care cases (PSI 7) (3.8 per1000).
- 17 cases of Postoperative Wound Dehiscence (PSI 14) (3.7per1000).
-1 Birth Trauma - Injury to Neonate case, and (PSI 17) (1.7 per 1000).
-18 Obstetric Trauma - Cesarean Delivery cases (PSI 20) (40 per 1000) were flagged by studied PSIs developed by AHRQ.

Comparing with the reported rates by other studies and AHRQ study in 2006, all of calculated indicators have inadequate condition; i.e. these are far from empirical estimated rates. The hospital administrators should be more sensitive to this issue and perform some improvement programs.