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ppt课件-a h r q slide template- o e c d（h r q幻灯片模板- o e c d）.ppt

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Assessing Patient Safety through Administrative Data:Adapting and Improving Existing Systems Patrick S. Romano, MD MPH Professor of Medicine and Pediatrics UC Davis School of Medicine Sacramento CA, USA June 29, 2006 Acknowledgments Support for Quality Indicators II (Contract No. 290-04-0020) Mamatha Pancholi, AHRQ Project Officer Marybeth Farquhar, AHRQ QI Senior Advisor Mark Gritz and Jeffrey Geppert, Project Directors, Battelle Health and Life Sciences Kathryn McDonald (PI) and Sheryl Davies (project manager), Stanford University Other clinical team members: Douglas Payne (medicine), Garth Utter (surgery), Shagufta Yasmeen (obstetrics gynecology), Corinna Haberland (pediatrics), Banafsheh Sadeghi (research assistant) Overview General approaches to assessing inpatient safety Rationale for using administrative data: strengths and limitations Background about the AHRQ Quality Indicators program Development and maintenance of the AHRQ Patient Safety Indicators (PSIs) OECD international expert panel review International interest in the AHRQ PSIs Practical issues associated with international application of the AHRQ PSIs Taxonomy of patient safety measures General approaches to assessing inpatient safety Analyze administrative data (adverse events, selected types of medical errors) Review medical records (adverse events, selected types of medical errors) Collect confidential provider reports of “incidents” or “safety events” (passive surveillance of medical errors or near misses) Conduct active surveillance or real-time observation (same) Survey patients Survey employees or managers on organizational capabilities or climate (“culture of safety”) Ethnographic observation to identify adverse events and errors Rationale for using administrative data Limitations Limited/no information on processes of care and physiologic measures of severity Limited/no information on timing (comorbidities vs. adverse events) Heterogeneous severity within some ICD codes Accuracy depend