Turley Christine B, Brittingham Jordan, Moonan Aunyika, Davis Dianne, Chakraborty Hrishikesh
J Healthc Qual. 2018 Sep/Oct;40(5):256-264. doi: 10.1097/JHQ.0000000000000092.
Meaningful improvement in patient safety encompasses a vast number of quality metrics, but a single measure to represent the overall level of safety is challenging to produce. Recently, Perla et al. established the Whole-Person Measure of Safety (WPMoS) to reflect the concept of global risk assessment at the patient level. We evaluated the WPMoS across an entire state to understand the impact of urban/rural setting, academic status, and hospital size on patient safety outcomes. The population included all South Carolina (SC) inpatient discharges from January 1, 2008, through to December 31, 2013, and was evaluated using established definitions of highly undesirable events (HUEs). Over the study period, the proportion of hospital discharges with at least one HUE significantly decreased from 9.7% to 8.8%, including significant reductions in nine of the 14 HUEs. Academic, large, and urban hospitals had a significantly lower proportion of hospital discharges with at least one HUE in 2008, but only urban hospitals remained significantly lower by 2013. Results indicate that there has been a decrease in harm events captured through administrative coded data over this 6-year period. A composite measure, such as the WPMoS, is necessary for hospitals to evaluate their progress toward reducing preventable harm.
患者安全方面的显著改善涵盖大量质量指标，但要制定一个单一指标来代表整体安全水平却颇具挑战。最近，佩拉等人建立了全人安全度量（WPMoS），以反映患者层面全球风险评估的概念。我们在全州范围内对WPMoS进行了评估，以了解城乡环境、学术地位和医院规模对患者安全结果的影响。研究人群包括2008年1月1日至2013年12月31日南卡罗来纳州（SC）所有住院患者出院病例，并使用既定的高度不良事件（HUEs）定义进行评估。在研究期间，至少发生一起HUE的医院出院病例比例从9.7%显著降至8.8%，其中14种HUE中有9种显著减少。学术型、大型和城市医院在2008年至少发生一起HUE的医院出院病例比例显著较低，但到2013年只有城市医院仍显著较低。结果表明，在这6年期间，通过行政编码数据捕获的伤害事件有所减少。对于医院评估其在减少可预防伤害方面的进展而言，像WPMoS这样的综合指标是必要的。
