Hogan H, Olsen S, Scobie S, Chapman E, Sachs R, McKee M, Vincent C, Thomson R
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Qual Saf Health Care. 2008 Jun;17(3):209-15. doi: 10.1136/qshc.2006.020008.
To assess the utility of data already existing within hospitals for monitoring patient safety.
An acute hospital in southern England.
Mapping of data sources proposed by staff as potentially able to identify patient safety issues followed by an in-depth analysis of the content of seven key sources. Data source analysis: For each data source: scope and depth of content in relation to patient safety, number and type of patient safety incidents identified, degree of overlap with incidents identified by different sources, levels of patient harm associated with incidents.
A wide range of data sources existing within the hospital setting have the potential to provide information about patient safety incidents. Poor quality of coding, delays in reports reaching databases, the narrow focus of some data sources, limited data-collection periods and lack of central collation of findings were some of the barriers to making the best use of routine data sources for monitoring patient safety. An in-depth analysis of seven key data sources (Clinical Incident database, Health and Safety Incident database, Complaints database, Claims database and Inquest database, the Patient Administration System and case notes) indicated that case notes have the potential to identify the largest number of incidents and provide the richest source of information on such incidents. The seven data sources identified different types of incidents with differing levels of patient harm. There was little overlap between the incidents identified by different sources.
Despite issues related to the quality of coding, depth of information available and accessibility, triangulating information from more than one source can identify a broader range of incidents and provide additional information related to professional groups involved, types of patients affected and important contributory factors. Such an approach can provide a focus for further work and ultimately contributes to the identification of appropriate interventions that improve patient safety.
评估医院现有数据在监测患者安全方面的效用。
英格兰南部的一家急症医院。
工作人员提议绘制可能能够识别患者安全问题的数据源，随后对七个关键数据源的内容进行深入分析。数据源分析：针对每个数据源：与患者安全相关的内容范围和深度、识别出的患者安全事件的数量和类型、与不同来源识别出的事件的重叠程度、与事件相关的患者伤害水平。
医院环境中存在的广泛数据源有可能提供有关患者安全事件的信息。编码质量差、报告到达数据库的延迟、一些数据源关注范围狭窄、数据收集期有限以及缺乏对结果的集中整理是充分利用常规数据源监测患者安全的一些障碍。对七个关键数据源（临床事件数据库、健康与安全事件数据库、投诉数据库、索赔数据库和死因裁判数据库、患者管理系统和病历）的深入分析表明，病历有可能识别出最多的事件，并提供有关此类事件最丰富的信息来源。这七个数据源识别出不同类型的事件，对患者造成的伤害程度也不同。不同来源识别出的事件之间几乎没有重叠。
尽管存在与编码质量、可用信息深度和可获取性相关的问题，但对来自多个来源的信息进行三角测量可以识别更广泛的事件范围，并提供与涉及的专业团体、受影响患者类型和重要促成因素相关的额外信息。这种方法可以为进一步的工作提供重点，并最终有助于确定改善患者安全的适当干预措施。
