Effect of patient safety strategies on the incidence of adverse events.

OBJECTIVE

This study aims to estimate the incidence of adverse events (AEs) and avoidable AE in four hospital services before and after applying strategies for patient safety.

DESIGN

Retrospective study of two cohorts (2006 and 2009).

SETTING

General Surgery, Internal Medicine, Intensive Care Unit and Oncology services.

PARTICIPANTS

A sample of 365 patients (2006) and 232 in 2009 randomly selected from the services previously cited.

INTERVENTIONS

Strategies to improve patient safety (e.g. hand-hygiene campaign).

MAIN OUTCOME MEASURES

Analyses were made of the change in the incidence and type of AE and avoidable AE, number of procedures and additional days of hospital stay, and the concordance between two recording systems.

RESULTS

The incidence of patients with AE was 20.8% in 2006 compared with 28.9% in 2009 (P < 0.05). Oncology had twofold more AE than did General Surgery [odds ratio (OR) = 2.07, 95% confidence interval (CI): 1.12-3.86] for the same length of stay and number of extrinsic risk factors. In 2006, 84.6% were considered avoidable, compared with 57.1% of 2009 (P < 0.001). There was no difference in the average length of additional stay. In 2006, there were more additional procedures compared to 2009 (OR = 2.75, 95% CI: 1.28-6.06). A concordance of 61% was found for the detection of AE with the two recording systems.

CONCLUSIONS

An increased incidence in AEs was found after the strategies, while avoidable AE decreased, as did additional treatments and procedures. The measures implemented constitute a further step in reducing avoidance and a greater awareness of recording AEs in the discharge report.