We have been asked to provide guidance on how the AHRQ Patient Safety Indicators will be presented in the 2011 hospital guide.
The 19 indicators are based on definitions created by the Agency for Healthcare Research and Quality in the US which recommends that hospitals track these indicators as means of monitoring patient safety. They are designed to be derived from routine administrative data and in most cases the objective is to reduce the rate of adverse events to zero.
In many cases, the data used for these indicators is poorly coded by many trusts. In these cases, the indicators are provided to trusts to help them improve data quality and then use the indicators internally to inform quality improvement initiatives.
As was the case last year, there are only three PSIs where we regard the data as robust enough to warrant public use of the data as an indicator of where a trust may be performing well or poorly.
- Deaths after surgery
- Deaths in low-risk diagnosis groups
- Obstetric trauma – vaginal delivery without instrument
The remaining 16 PSIs (see below) are a helpful indicator within Dr Foster’s quality solution, Real time Monitoring, that assist in recognising trends, drilling down into individual patient records and in monitoring performance.
Recently, some of these 16 PSIs were published on the Dr Foster website highlighting some trusts as performing poorly. These have now been removed from the website and will not be used in this form in the 2011 Hospital Guide or related website.
PSIs can be a very helpful indicator for reducing costs and improving the quality of care. There are a number of simple measures that could be taken – such as mandating a ‘present on admission’ flag be recorded in the coding as part of the national data set, where as currently this only happens indiscriminately at a local level. The 2011 Hospital Guide will be addressing these issues in more detail in November. Further information about the Indicators to be used in the Hospital Guide will be released in the coming weeks.
Should you have any questions please contact your regional Customer Support Manager (CSM) for more information. If you do not know who your CSM is please call 0800 288 9810.
Patient Safety Indicators that will not be used to measure trust performance
- Decubitus ulcer by length of stay (national rate only) rate per LOS band
- Decubitus ulcer by age (national rate only) rate by age band
- Decubitus ulcer by admission type (national rate only) elective, non-elective, transfer etc
- Decubitus ulcer by source of admission (national rate only)
- Infections associated with central line
- Post-operative hip fracture
- Post-op Haemorrhage or Haematoma
- Post-operative physiologic and metabolic derangements
- Post-operative respiratory failure
- Post-operative pulmonary embolism or deep vein thrombosis
- Post-operative sepsis
- Post-operative wound dehiscence
- Accidental puncture or laceration
- Obstetric trauma – vaginal delivery with instrument