Evaluating the patient safety indicators: How well do they perform on Veterans Health Administration data?

Amy K. Rosen, Peter Rivard, Shibei Zhao, Susan Loveland, Dennis Tsilimingras, Cindy L. Christiansen, Anne Elixhauser, Patrick S Romano

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Background: The Patient Safety Indicators (PSIs), an administrative data-based tool developed by the Agency for Healthcare Research and Quality, are increasingly being used to screen for potential in-hospital patient safety problems. Although the Veterans Health Administration (VA) is a national leader in patient safety, accurate information on the epidemiology of patient safety events in the VA is still unavailable. Objectives: Our objectives were to: (1) apply the AHRQ PSI software to VA administrative data to identify potential instances of compromised patient safety; (2) determine occurrence rates of PSI events in the VA; and (3) examine the construct validity of the PSIs. Methods: We examined differences between observed and risk-adjusted PSI rates in the VA, compared VA and non-VA PSI rates, and investigated the construct validity of the PSIs by examining correlations of the PSIs with other outcomes of VA hospitalizations. Results: We identified 11,411 PSI events in the VA nationwide in FY'01. Observed PSI rates per 1000 discharges ranged from 0.007 for "transfusion reaction" to 155.5 for "failure to rescue." There were significant, although small, differences between VA and non-VA risk-adjusted PSI rates. Hospitalizations with PSI events had longer lengths of stay, higher mortality, and higher costs than those without PSI events. Conclusions: Our results suggest that the PSIs may be useful as a patient safety screening tool in the VA. Our PSI rates were consistent with the national incidence of low rates; however, differences between VA and non-VA rates suggest that inadequate case-mix adjustment may be contributing to these findings.

Original languageEnglish (US)
Pages (from-to)873-884
Number of pages12
JournalMedical Care
Volume43
Issue number9
DOIs
StatePublished - Sep 2005

Fingerprint

Veterans Health
United States Department of Veterans Affairs
Patient Safety
health
event
construct validity
hospitalization
Health
Hospitalization
epidemiology

Keywords

  • Administrative data
  • Adverse events
  • Medical errors
  • Patient safety
  • Quality indicators

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Evaluating the patient safety indicators : How well do they perform on Veterans Health Administration data? / Rosen, Amy K.; Rivard, Peter; Zhao, Shibei; Loveland, Susan; Tsilimingras, Dennis; Christiansen, Cindy L.; Elixhauser, Anne; Romano, Patrick S.

In: Medical Care, Vol. 43, No. 9, 09.2005, p. 873-884.

Research output: Contribution to journalArticle

Rosen, AK, Rivard, P, Zhao, S, Loveland, S, Tsilimingras, D, Christiansen, CL, Elixhauser, A & Romano, PS 2005, 'Evaluating the patient safety indicators: How well do they perform on Veterans Health Administration data?', Medical Care, vol. 43, no. 9, pp. 873-884. https://doi.org/10.1097/01.mlr.0000173561.79742.fb
Rosen, Amy K. ; Rivard, Peter ; Zhao, Shibei ; Loveland, Susan ; Tsilimingras, Dennis ; Christiansen, Cindy L. ; Elixhauser, Anne ; Romano, Patrick S. / Evaluating the patient safety indicators : How well do they perform on Veterans Health Administration data?. In: Medical Care. 2005 ; Vol. 43, No. 9. pp. 873-884.
@article{d6aed7e19c5348409ae8caed4cc8c045,
title = "Evaluating the patient safety indicators: How well do they perform on Veterans Health Administration data?",
abstract = "Background: The Patient Safety Indicators (PSIs), an administrative data-based tool developed by the Agency for Healthcare Research and Quality, are increasingly being used to screen for potential in-hospital patient safety problems. Although the Veterans Health Administration (VA) is a national leader in patient safety, accurate information on the epidemiology of patient safety events in the VA is still unavailable. Objectives: Our objectives were to: (1) apply the AHRQ PSI software to VA administrative data to identify potential instances of compromised patient safety; (2) determine occurrence rates of PSI events in the VA; and (3) examine the construct validity of the PSIs. Methods: We examined differences between observed and risk-adjusted PSI rates in the VA, compared VA and non-VA PSI rates, and investigated the construct validity of the PSIs by examining correlations of the PSIs with other outcomes of VA hospitalizations. Results: We identified 11,411 PSI events in the VA nationwide in FY'01. Observed PSI rates per 1000 discharges ranged from 0.007 for {"}transfusion reaction{"} to 155.5 for {"}failure to rescue.{"} There were significant, although small, differences between VA and non-VA risk-adjusted PSI rates. Hospitalizations with PSI events had longer lengths of stay, higher mortality, and higher costs than those without PSI events. Conclusions: Our results suggest that the PSIs may be useful as a patient safety screening tool in the VA. Our PSI rates were consistent with the national incidence of low rates; however, differences between VA and non-VA rates suggest that inadequate case-mix adjustment may be contributing to these findings.",
keywords = "Administrative data, Adverse events, Medical errors, Patient safety, Quality indicators",
author = "Rosen, {Amy K.} and Peter Rivard and Shibei Zhao and Susan Loveland and Dennis Tsilimingras and Christiansen, {Cindy L.} and Anne Elixhauser and Romano, {Patrick S}",
year = "2005",
month = "9",
doi = "10.1097/01.mlr.0000173561.79742.fb",
language = "English (US)",
volume = "43",
pages = "873--884",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Evaluating the patient safety indicators

T2 - How well do they perform on Veterans Health Administration data?

AU - Rosen, Amy K.

AU - Rivard, Peter

AU - Zhao, Shibei

AU - Loveland, Susan

AU - Tsilimingras, Dennis

AU - Christiansen, Cindy L.

AU - Elixhauser, Anne

AU - Romano, Patrick S

PY - 2005/9

Y1 - 2005/9

N2 - Background: The Patient Safety Indicators (PSIs), an administrative data-based tool developed by the Agency for Healthcare Research and Quality, are increasingly being used to screen for potential in-hospital patient safety problems. Although the Veterans Health Administration (VA) is a national leader in patient safety, accurate information on the epidemiology of patient safety events in the VA is still unavailable. Objectives: Our objectives were to: (1) apply the AHRQ PSI software to VA administrative data to identify potential instances of compromised patient safety; (2) determine occurrence rates of PSI events in the VA; and (3) examine the construct validity of the PSIs. Methods: We examined differences between observed and risk-adjusted PSI rates in the VA, compared VA and non-VA PSI rates, and investigated the construct validity of the PSIs by examining correlations of the PSIs with other outcomes of VA hospitalizations. Results: We identified 11,411 PSI events in the VA nationwide in FY'01. Observed PSI rates per 1000 discharges ranged from 0.007 for "transfusion reaction" to 155.5 for "failure to rescue." There were significant, although small, differences between VA and non-VA risk-adjusted PSI rates. Hospitalizations with PSI events had longer lengths of stay, higher mortality, and higher costs than those without PSI events. Conclusions: Our results suggest that the PSIs may be useful as a patient safety screening tool in the VA. Our PSI rates were consistent with the national incidence of low rates; however, differences between VA and non-VA rates suggest that inadequate case-mix adjustment may be contributing to these findings.

AB - Background: The Patient Safety Indicators (PSIs), an administrative data-based tool developed by the Agency for Healthcare Research and Quality, are increasingly being used to screen for potential in-hospital patient safety problems. Although the Veterans Health Administration (VA) is a national leader in patient safety, accurate information on the epidemiology of patient safety events in the VA is still unavailable. Objectives: Our objectives were to: (1) apply the AHRQ PSI software to VA administrative data to identify potential instances of compromised patient safety; (2) determine occurrence rates of PSI events in the VA; and (3) examine the construct validity of the PSIs. Methods: We examined differences between observed and risk-adjusted PSI rates in the VA, compared VA and non-VA PSI rates, and investigated the construct validity of the PSIs by examining correlations of the PSIs with other outcomes of VA hospitalizations. Results: We identified 11,411 PSI events in the VA nationwide in FY'01. Observed PSI rates per 1000 discharges ranged from 0.007 for "transfusion reaction" to 155.5 for "failure to rescue." There were significant, although small, differences between VA and non-VA risk-adjusted PSI rates. Hospitalizations with PSI events had longer lengths of stay, higher mortality, and higher costs than those without PSI events. Conclusions: Our results suggest that the PSIs may be useful as a patient safety screening tool in the VA. Our PSI rates were consistent with the national incidence of low rates; however, differences between VA and non-VA rates suggest that inadequate case-mix adjustment may be contributing to these findings.

KW - Administrative data

KW - Adverse events

KW - Medical errors

KW - Patient safety

KW - Quality indicators

UR - http://www.scopus.com/inward/record.url?scp=24944523161&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=24944523161&partnerID=8YFLogxK

U2 - 10.1097/01.mlr.0000173561.79742.fb

DO - 10.1097/01.mlr.0000173561.79742.fb

M3 - Article

C2 - 16116352

AN - SCOPUS:24944523161

VL - 43

SP - 873

EP - 884

JO - Medical Care

JF - Medical Care

SN - 0025-7079

IS - 9

ER -