Understanding safer practices in health care: a prologue for the role of indicators

• Published in: Journal of evaluation in clinical practice 2005-04, Vol.11 (2), p.161-170
• Main Authors: Kazandjian, Vahé A., Wicker, Karol, Ogunbo, Sam, Silverman, Nicole
• Format: Article
• Language: English
• Subjects: accountability; Databases as Topic; Europe; Humans; indicators of safety; Least-Squares Analysis; Quality Indicator Project; Quality Indicators, Health Care - utilization; Retrospective Studies; Risk Management - methods; Taiwan; United States; value-free measures
• ISSN: 1356-1294; 1365-2753
• DOI: 10.1111/j.1365-2753.2005.00516.x

Objectives  Patient safety and safer practices are central themes to many national strategies for accountability. The multinational Quality Indicator Project® (QI Project®) database is used to identify patterns of indicator use to measure safety of care in Asia, Europe, and the USA. The second objective is to assess, within the context of an indicator project, the usefulness of indicators to measure errors or mishaps.  Design and setting   This descriptive study retrospectively analyses indicator use patterns among hospitals in Asia, Europe, and the USA. The QI Project® database is used for the 1999–2002 period. Statistical testing (P‐value) of the differences in use percentages across five countries is based on ‘country’ rather than ‘hospital’ as the unit of analysis. Results  There was a significant increase in overall QI Project® indicator use worldwide between 1999 and 2002. The average change in use was 6.8% for safety indicators and 4.2% for all other indicators. When analysed by country (USA, Austria, Belgium, UK, and Taiwan), the average increases in use percentage were highest in Taiwan and Belgium. When the country‐specific differences were tested for significance, Taiwan showed the largest (and statistically significant) increase in safety indicator use between 1999 and 2002 (P