A SSESSING P ATIENT S AFETY T HROUGH A DMINISTRATIVE D ATA A DAPTING AND I MPROVING E XISTING S YSTEMS.


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A SSESSING P ATIENT S AFETY T HROUGH A DMINISTRATIVE D ATA A DAPTING AND I MPROVING E XISTING S YSTEMS "THE NORDIC PATIENT SAFETY GROUP" Leifur Bardarson MD, Chief Medical Doctor Department of Quality Assurance Landspitali – University Hospital Reykjavik ICELAND Leifur Bardarson MD Landspitali - University Hospital ICELAND

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Nordic Council of Ministers 2000 – 2003 W ORKING G ROUP ON Q UALITY M EASUREMENTS IN H EALTH C ARE Q UALITY I NDICATORS Q UALITY D ECLARATION

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Nordic Council of Ministers 2004 – 2006 WORKING GROUP ON QUALITY INDICATORS IN HEALTH CARE Charman: Jens Gøttrik, Chief Medical Officer, Danmark G ENERIC AND S PECIFIC I NDICATORS M ENTAL H EALTH P RIMARY C ARE P REVENTIVE M EASURES P ATIENT P ERSPECTIVE P ATIENT S AFETY

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THERE ARE HUNDREDS OF WELL DEFINED INDICATORS THE INDICATOR JOURNEY OF THE GROUP THE INDICATOR BUFFET Leifur Bardarson MD Landspitali - University Hospital ICELAND

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THE INDICATOR JOURNEY OF THE GROUP THE INDICATOR BUFFET OECD AHRQ Norway WHO Denmark Sweden Leifur Bardarson MD Landspitali - University Hospital ICELAND

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THE INDICATOR JOURNEY OF THE GROUP DID THEY TASTE GOOD ? Leifur Bardarson MD Landspitali - University Hospital ICELAND

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EXAMPLES OF "DISHES" ON THE INDICATOR BUFFET TABLE INDICATORS FROM OECD Postoperative aspiratory embolism or profound vein thrombosis Post operation sepsis Obstetric injury vaginal Postoperative hipfracture Decubitus ulcers Wrong site surgery Complications af aneasthesia OTHER INDICATORS Hospital contaminations Foreign body left amid method Safety society Reoperations Prescription and circulation of pharmaceuticals Death in Low-mortality DRGs Interactions af pharmaceuticals Patient wellbeing surveys Audit of restorative records Readmissions Leifur Bardarson MD Landspitali - University Hospital ICELAND

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Jes Søgaard 1982 Leifur Bardarson MD Landspitali - University Hospital ICELAND

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THE GROUPS PRESENT MENU OECD INDICATORS Standardized IN-HOSPITAL MORTALITY IHI\'s TRIGGER TOOLS SAFETY CULTURE (AHRQ) Leifur Bardarson MD Landspitali - University Hospital ICELAND

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SAFETY CULTURE Shared qualities (what is vital) and convictions (how things work) that associate with an association\'s structure and control frameworks to deliver behavioral standards (the way we do things around here). (James Reason 2006) UNSPOKEN NORMS Leifur Bardarson MD Landspitali - University Hospital ICELAND

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1/11.000.000 1/250.000 S AFETY C ULTURE Western carrier Airline from previous eastern Europe Probability of lethal result DIFFERENCE = CULTURE Health Care 1/1.000 Leifur Bardarson MD Landspitali - University Hospital ICELAND

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P ATIENT S AFETY C ULTURE AHRQ HSPSC Hospital Survey on Patient Safety Culture Indicator ?: Evaluation of patient security society Leifur Bardarson MD Landspitali - University Hospital ICELAND

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Postoperative aspiratory embolism or profound vein thrombosis OECD INDICATOR PS 07 - AHRQ PSI 12 Definition: Cases of profound vein thrombosis (DVT) or pulmonary embolism (PE) per 100.000 population Leifur Bardarson MD Landspitali - University Hospital ICELAND

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"NEW" INDICATOR PS 07,1 Postoperative pneumonic embolism or profound vein thrombosis after knee or hip substitution Definition: Cases of profound vein thrombosis (DVT) or pulmonary embolism (PE) per 100.000 population. Operational strategies: Knee and hip substitutions. *) Richard FO, et al.The commonness of venous thromboembolism after hip and knee substitution surgery. Restorative Journal of Australia 2005; 182: 154-160. Leifur Bardarson MD Landspitali - University Hospital ICELAND

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Post operation sepsis OECD INDICATOR PS 08 - AHRQ PSI 12 Definition: Cases of sepsis per 100.000 populace with an working room methods Leifur Bardarson MD Landspitali - University Hospital ICELAND

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"NEW" INDICATOR PS 08,1 Post operation sepsis after knee or hip substitutions Definition: Cases of sepsis per 100.000 populace with an working room methodology *) Nasser S. The rate of sepsis after aggregate hip replacemant arthroplasty. Classes in Arthroplasrty 1994; 5:153-159. Leifur Bardarson MD Landspitali - University Hospital ICELAND

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"NEW" INDICATOR PS 08,2 Post operation sepsis after Bowel surgery Definition: Cases of sepsis per 100.000 population with a working room methods Leifur Bardarson MD Landspitali - University Hospital ICELAND

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Obstetric injury vaginal OECD INDICATOR PS 17 Definition: Percentage (%) of vaginal lacerations (third or fourth degree lacerations) of vaginal conveyances Leifur Bardarson MD Landspitali - University Hospital ICELAND

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Obstetric injury vaginal OECD INDICATOR PS 17 How to present this information to clients Leifur Bardarson MD Landspitali - University Hospital ICELAND

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Foreign body left amid strategy Leifur Bardarson MD Landspitali - University Hospital ICELAND

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S UMMARY There exist numerous logically approved patient wellbeing markers We have encountered insufficient documentation in our authoritative datasystems We need to live with that By dividing pointers it is perhaps conceivable confirm if existing regulatory information are mirroring this present reality Leifur Bardarson MD Landspitali - University Hospital ICELAND

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SAFETY CAN BE LOOKED AT FROM MANY DIFFERENT ASPECTS Leifur Bardarson MD Landspitali - University Hospital ICELAND

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