OBJECTIVE: The aim was to develop an electronic adverse event (AE) screening tool applicable to acute care hospital episodes for patients admitted with chronic heart failure (CHF) and pneumonia.
DESIGN: Consensus building using a modified Delphi method and descriptive analysis of hospital discharge data.
PARTICIPANTS: Consultant physicians in general medicine (n = 38).
INTERVENTION: In-hospital acquired (C-prefix) diagnoses associated with CHF and pneumonia admissions to 230 hospitals in Victoria, Australia, were extracted from the Victorian Admitted Episodes Data Set between July 2004 and June 2007. A 9-point rating scale was used to prioritize diagnoses acquired during hospitalization (routinely coded as a 'C-prefix' diagnosis to distinguish from diagnoses present on admission) for inclusion within an AE screening tool. Diagnoses rated a group median score between 7 and 9 by the physician panel were included.
MAIN OUTCOME MEASURES: Selection of C-prefix diagnoses with a group median rating of 7-9 in a screening tool, and the level of physician agreement, as assessed using the Interpercentile Range Adjusted for Symmetry.
RESULTS: Of 697 initial C-prefix diagnoses, there were high levels of agreement to include 113 (16.2%) in the AE screening tool. Using these selected diagnoses, a potential AE was flagged in 14% of all admissions for the two index conditions. Intra-rater reliability for each clinician ranged from kappa 0.482 to 1.0.
CONCLUSIONS: A high level of physician agreement was obtained in selecting in-hospital diagnoses for inclusion in an AE screening tool based on routinely collected data. These results support further tool validation.
}, year = {2012}, journal = {Int J Qual Health Care}, volume = {24}, pages = {266-78}, month = {06/2012}, issn = {1464-3677}, doi = {10.1093/intqhc/mzs007}, language = {eng}, }