Whole-patient measure of safety: using administrative data to assess the probability of highly undesirable events during hospitalization.

Rocco J. Perla; Samuel Hohmann; Karen Annis

Study

Whole-patient measure of safety: using administrative data to assess the probability of highly undesirable events during hospitalization.

November 20, 2013

Perla RJ, Hohmann S, Annis K. J Healthc Qual. 2013;35(5):20-31.

View more articles from the same authors.

This study used screening of administrative data to determine the overall probability of an individual patient experiencing an adverse event during hospitalization.

PubMed citation

Available at

Related Resources From the Same Author(s)

The "physician-led chart audit": engaging providers in fortifying a culture of safety.

March 19, 2014

Patient outcomes after the introduction of statewide ICU nurse staffing regulations.

September 26, 2018

Interhospital transfer patients discharged by academic hospitalists and general internists: characteristics and outcomes.

January 6, 2016

Assessing the dangers of a hospital stay for patients with developmental disability In England, 2017–19.

October 19, 2022

Impact of hospital-acquired pneumonia on the Medicare program.

November 8, 2023

Association of hospital participation in a surgical outcomes monitoring program with inpatient complications and mortality.

February 18, 2015

Exploring the role of patients in promoting safety: policy to practice.

February 17, 2010

Sent home to die.

September 16, 2020

Mortality rate after nonelective hospital admission.

June 1, 2011

Adverse drug events in hospitalized cardiac patients.

November 7, 2007

Temporal trends in patient safety in the Netherlands: reductions in preventable adverse events or the end of adverse events as a useful metric?

August 5, 2015

Moving beyond the weekend effect: how can we best target interventions to improve patient care?

June 30, 2021

Identifying adverse events: reflections on an imperfect gold standard after 20 years of patient safety research.

March 25, 2020

"Tech-check-tech": a review of the evidence on its safety and benefits.

October 5, 2011

Surgical adverse outcomes and patients’ evaluation of quality of care: inherent risk or reduced quality of care?

December 12, 2007

Do patient safety indicators explain increased weekend mortality?

September 2, 2015

Attitudes and barriers to a medical emergency team system at a tertiary paediatric hospital.

January 5, 2011

The problem with using patient complaints for improvement.

January 17, 2018

Learning from morbidity and mortality conferences: focus and sustainability of lessons for patient care.

April 28, 2021

Anticoagulation-associated adverse drug events.

December 14, 2011

What 'just culture' doesn't understand about just punishment.

September 12, 2018

Analysis of adverse events in pediatric surgery using criteria validated from the adult population: justifying the need for pediatric-focused outcome measures.

August 11, 2010

Translating staff experience into organisational improvement: the HEADS-UP stepped wedge, cluster controlled, non-randomised trial.

November 1, 2017

The association between complications, incidents, and patient experience: retrospective linkage of routine patient experience surveys and safety data.

March 27, 2019

Identifying high-alert medications in a university hospital by applying data from the medication error reporting system.

August 16, 2017

Improved medication management with introduction of a perioperative and prescribing pharmacist service.

August 12, 2020

Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint data.

August 15, 2018

Systemic vulnerabilities to suicide among veterans from the Iraq and Afghanistan conflicts: review of case reports from a national Veterans Affairs database.

April 20, 2011

Adverse events in emergency department boarding: a systematic review.

August 18, 2021

The role of surgeon error in withdrawal of postoperative life support.

September 26, 2012

In support of the medical apology: the nonlegal arguments.

October 5, 2016

Building patient trust in hospitals: a combination of hospital-related factors and health care clinician behaviors.

October 27, 2021

Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable?

October 4, 2006

"First, do no harm": balancing competing priorities in surgical practice.

October 10, 2012

Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities.

January 20, 2016

Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.

September 9, 2015

Views of practicing physicians and the public on medical errors.

March 27, 2005

Changing smart pump vendors: lessons learned.

December 14, 2016

Frequency and type of situational awareness errors contributing to death and brain damage: a closed claims analysis.

May 24, 2017

Surgeon-reported conflict with intensivists about postoperative goals of care.

March 27, 2013

Children's hospitals' solutions for patient safety collaborative impact on hospital-acquired harm.

September 6, 2017

Types and origins of diagnostic errors in primary care settings.

March 6, 2013

Translating concerns into action: a detailed qualitative evaluation of an interdisciplinary intervention on medical wards.

April 26, 2017

Diagnostic errors in the intensive care unit: a systematic review of autopsy studies.

August 8, 2012

Missed steps in the preanesthetic set-up.

April 27, 2011

Association of measured quality with financial health among U.S. hospitals.

May 4, 2022

Systematic review: nurses' safety attitudes and their impact on patient outcomes in acute-care hospitals.

October 27, 2021

"Plans are worthless, but planning is everything": advancing patient safety by better managing the paradox of planning versus adaptation.

March 6, 2024

Preventing potential patient harm through clinical content interventions during oncology clinical trial implementation.

September 20, 2023

Self-reported violations during medication administration in two paediatric hospitals.

May 16, 2012

Telemedicine vs telephone consultations and medication prescribing errors among referring physicians: a cluster randomized crossover trial.

March 13, 2024

Rural nurses' safeguarding work: reembodying patient safety.

June 15, 2011

Effective communication with primary care providers.

October 1, 2014

Guidelines in Practice: prevention of unintentionally retained surgical items.

December 7, 2022

'I'm smiling under here': Masks, plexiglass and questions the norm as hospitals lure patients back in COVID-19 era.

June 17, 2020

A framework for classifying factors that contribute to error in the emergency department.

March 6, 2005

A comprehensive departmental care review model: requirements, structure, and flow.

June 30, 2021

Agreement of expert judgment in causality assessment of adverse drug reactions.

May 4, 2005

Identifying and reducing medication errors in psychiatry: creating a culture of safety through the use of an adverse event reporting mechanism.

April 6, 2011

Increasing rate of detection of wrong-patient radiographs: use of photographs obtained at time of radiography.

June 12, 2013

Improving the quality and safety of care on the medical ward: a review and synthesis of the evidence base.

January 14, 2015

Association of measured quality and future financial performance among hospitals performing cardiac surgery.

December 7, 2022

Profiles in patient safety: a "perfect storm" in the emergency department.

June 20, 2007

Passing the baton: a grounded practical theory of handoff communication between multidisciplinary providers in two Department of Veterans Affairs outpatient settings.

September 5, 2012

Clinical reasoning education at US medical schools: results from a national survey of internal medicine clerkship directors.

September 13, 2017

Adapting cognitive task analysis to investigate clinical decision making and medication safety incidents.

September 18, 2019

Electronic health record-based surveillance of diagnostic errors in primary care.

November 2, 2011

Incidence and OR team awareness of “near-miss” and retained surgical sharps: a national survey on United States operating rooms.

June 23, 2021

Inadequate health literacy among paid caregivers of seniors.

January 30, 2005

Student perceptions of clinical quality and safety.

November 9, 2016

Rethinking medical ward quality.

November 9, 2016

Applying Lean methods to improve quality and safety in surgical sterile instrument processing.

March 13, 2013

The impact of safety culture, quality of care, missed care and nurse staffing on patient falls: a multisource association study.

June 28, 2023

Healthcare-associated infections in adult intensive care units: a multisource study examining nurses' safety attitudes, quality of care, missed care, and nurse staffing.

August 16, 2023

Hospitalists as Emerging Leaders in Patient Safety: lessons learned and future directions.

February 25, 2009

Adolescent use of insulin and patient-controlled analgesia pump technology: a 10-year Food and Drug Administration retrospective study of adverse events.

May 28, 2008

Hospitalists as emerging leaders in patient safety: targeting a few to affect many.

August 31, 2005

Intravenous smart pumps: usability issues, intravenous medication administration error, and patient safety.

July 11, 2018

Integrating knowledge-based resources into the electronic health record: history, current status, and role of librarians.

August 29, 2007

Is employee discipline the solution for patient safety?

January 4, 2006

Physicians' views of interventions to reduce medical errors: does evidence of effectiveness matter?

April 21, 2005

Doing well by doing good: assessing the cost savings of an intervention to reduce central line-associated bloodstream infections in a Hawaii hospital.

June 12, 2013

A mixed method study of the merits of e-prescribing drug alerts in primary care.

April 30, 2008

Effective discharge communication in the emergency department.

February 1, 2012

Knowledge retention after simulated crisis: importance of independent practice and simulated mortality.

June 5, 2019

Strength of improvement recommendations from injurious fall investigations: a retrospective multi-incident analysis.

April 13, 2022

Parent participation in morbidity and mortality review: parent and physician perspectives.

June 22, 2022

Correlation between hospital rating agencies' data: an analysis and recommendation.

June 10, 2020

Waking up the next morning: surgeons' emotional reactions to adverse events.

December 12, 2012

How can the criminal law support the provision of quality in healthcare?

April 16, 2014

Knowledge-based information to improve the quality of patient care.

February 25, 2009

Quality improvement to decrease specimen mislabeling in transfusion medicine.

September 20, 2006

Profiles in patient safety: authority gradients in medical error.

March 6, 2005

Factors associated with unanticipated day of surgery deaths in Department of Veterans Affairs hospitals.

December 17, 2008

Outcomes of emergency department patients presenting with adverse drug events.

March 16, 2011

About politeness, face, and feedback: exploring resident and faculty perceptions of how institutional feedback culture influences feedback practices.

September 26, 2018

The disclosure of unanticipated outcomes of care and medical errors: what does this mean for anesthesiologists?

June 29, 2011

Preventing in-facility pressure ulcers as a patient safety strategy: a systematic review.

March 20, 2013

Medication administration errors: understanding the issues.

April 26, 2006

Ambiguities of chronic illness management and challenges to the medical error paradigm.

November 8, 2006

Related Resources

Prevalence, risk factors, and outcomes of idle intravenous catheters: an integrative review.

August 3, 2016

Temporal trends in patient safety in the Netherlands: reductions in preventable adverse events or the end of adverse events as a useful metric?

August 5, 2015

Data as a catalyst for change: stories from the frontlines.

February 11, 2015

A qualitative study of systemic influences on paramedic decision making: care transitions and patient safety.

January 28, 2015

Racial and ethnic disparities in patient safety.

August 27, 2014

National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations.

March 26, 2014

Medication administration errors in hospitals—challenges and recommendations for their measurement.

March 26, 2014

Medication errors in hospitalised children.

March 12, 2014

Failure events in transition of care for surgical patients.

March 5, 2014

National trends in patient safety for four common conditions, 2005–2011.

January 29, 2014

Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study.

January 22, 2014

Medication regimen complexity and hospital readmission for an adverse drug event.

January 15, 2014

The Orthopaedic Error Index: development and application of a novel national indicator for assessing the relative safety of hospital care using a cross-sectional approach.

December 18, 2013

Suffering in silence: a qualitative study of second victims of adverse events.

November 27, 2013

Increasing demands for quality measurement.

November 27, 2013

Do variations in hospital mortality patterns after weekend admission reflect reduced quality of care or different patient cohorts? A population-based study.

November 20, 2013

Compensation of chief executive officers at nonprofit US hospitals.

October 30, 2013

Approval and perceived impact of duty hour regulations: survey of pediatric program directors.

October 23, 2013

Prescribing errors on admission to hospital and their potential impact: a mixed-methods study.

October 16, 2013

The relationship between the nursing work environment and the occurrence of reported paediatric medication administration errors: a pan Canadian study.

October 2, 2013

Engaging patients in medication reconciliation via a patient portal following hospital discharge.

October 2, 2013

How many die from medical mistakes in US hospitals?

October 2, 2013

Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients.

September 25, 2013

Drug administration errors in hospital inpatients: a systematic review.

August 14, 2013

A new, evidence-based estimate of patient harms associated with hospital care.

August 7, 2013

Potentially inappropriate medications in a large cohort of patients in geriatric units: association with clinical and functional characteristics.

June 19, 2013

Resident Projects for Improvement.

June 19, 2013

PCA safety data review after clinical decision support and smart pump technology implementation.

June 12, 2013

Determining a patient's comfort in inquiring about healthcare providers' hand-washing behavior.

June 12, 2013

The long road to ensuring patient safety in NHS hospitals.

June 12, 2013

See More About The Topic

Hospitals

Risk Managers

General Internal Medicine

Hospital Medicine

Epidemiology of Errors and Adverse Events

Whole-patient measure of safety: using administrative data to assess the probability of highly undesirable events during hospitalization.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Whole-patient measure of safety: using administrative data to assess the probability of highly undesirable events during hospitalization.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site