One patient safety indicator may offer a glimpse at a hospital's overall safety record
Research Activities, March 2010, No. 355
The Patient Safety Indicators (PSIs) from the Agency for Healthcare Research and Quality (AHRQ) let health system leaders identify potential adverse events that can occur during hospitalization. Researchers from the RAND Corporation analyzed 19 PSIs to determine if any of them could act as "canary measures" to serve as barometers of broad safety trends. (The term "canary measure" comes from coal miners' use of canaries, whose sudden silences warned miners that deadly gases were present.)
The researchers found that PSI #7, selected infections due to medical care, was the best canary of the PSIs. It was correlated with 10 of the 18 other PSIs and was associated with common risk factors at the institutional level. Conversely, PSI #1, complications of anesthesia, and PSI #17, birth trauma—injury to neonate, were the least correlated with other PSIs.
The researchers suggest that PSI #7 may offer a way for hospital staff to detect general trends in safety by examining fewer safety measures. Because most of the correlations between PSIs were driven by hospital-level factors, the authors recommend that future interventions focus on reducing risks that occur across all hospitals. This study, which used the Nationwide Inpatient Sample from AHRQ's Healthcare Cost and Utilization Project, was funded in part by AHRQ (Contract No. 290-02-0010).
See "'Canary measures' among the AHRQ patient safety indicators," by Hao Yu, Ph.D., Michael D. Greenberg, J.D., Ph.D., Amelia M. Haviland, Ph.D., and Donna O. Farley, Ph.D., in the November/December 2009 American Journal of Medical Quality 24(6), pp. 465-473.