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Measuring Patient Harm in Canadian Hospitals and Driving Improvement


The Canadian Institute for Health Information and Canadian Patient Safety Institute have worked together to develop a new measure of harm in hospitals that is linked to evidence‑informed practice that can drive improvement.

Measuring hospital harm

Currently, there is no single measure that provides an overall perspective on patient safety in Canadian hospitals.
Harm is typically measured by small dot (specific event) indicators, voluntary self-reporting, the Global Trigger tool or chart review.
These methods are not easily reproducible or comprehensive enough to monitor the universe of patient safety in Canadian hospitals on a regular basis.
This work answers questions such as
• How often do patients experience health care–associated harm?
•What types of health care–associated harm are most frequent?
•What evidence-informed practices can reduce harm in acute care hospitals?

Potential limitations

All occurrences of harm have equal weight, regardless of severity.

Differences in documentation and coding practices across hospitals may result in under- or over-reporting certain occurrences of harm.

Hospital Harm Definition

The rate of acute care hospitalizations with at least 1 occurrence of unintended harm that could have potentially been prevented by implementing known evidence‑informed practices.

•Harm must have occurred after admission, and required treatment or prolonged the hospital stay.

•Harm is categorized into 31 clinical groups, each of which is associated with evidence-informed practices.

CIHI and CPSI hospital harm products

•A new methodology for monitoring variations in patient safety in inpatient acute care settings
•Designed to help organizations identify patient safety improvement priorities and track progress over time

Improvement Resource
•Links the measure and improvement by providing evidence-informed practices to support patient safety improvement efforts.
•For each clinical group:
  ––Evidence-informed practices to reduce the likelihood of harm
  ––Outcome and process improvement measures
  ––Associated Accreditation Canada standards and Required Organizational Practices
  ––Links to additional resources
  ––Importance to patients and families (from the perspective of members of Patients for Patient Safety Canada)

•Introduces the measure and the improvement resources
•Provides a big picture view of hospital harm in Canada
•Identifies how measurement can be used for improvement

Future steps
CIHI and CPSI will continue to work with hospitals in order to understand and improve the data behind the measure and to investigate the feasibility of developing a risk-adjustment methodology to improve comparability.

For more information: [email protected]

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