The three-part model for coding causes and mechanisms of healthcare-related adverse events

Danielle A. Southern, James E. Harrison, Patrick S. Romano, Marie Annick Le Pogam, Harold A. Pincus, William A. Ghali

Research output: Contribution to journalReview articlepeer-review


ICD-11 provides a promising new way to capture healthcare-related harm or injury. In this paper, we elaborate on the framework for describing healthcare-related events where there is a presumed causal link between an event and underlying healthcare-related factors. The three-part model for describing healthcare-related harm or injury in ICD-11 consists of (1) a healthcare-related activity that is the cause of injury or other harm (selected from Chapter 23 of ICD-11); (2) a mode or mechanism of injury or harm, related to the underlying cause (also from Chapter 23 of ICD-11); and (3) the harmful consequences of the event to the patient, selected from any of Chapters 1 through 22 of ICD-11 (most importantly, the injury or harm experienced by the patient). Concepts from these three elements are linked/clustered through postcoordination to reflect the three-part model in a single coded expression. ICD-11 contains many novel features, and the three-part model described here for healthcare-related adverse events is a notable example.

Original languageEnglish (US)
Article number376
JournalBMC Medical Informatics and Decision Making
StatePublished - Nov 2021


  • Adverse events
  • ICD11
  • International Classification of Diseases
  • Quality and safety

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics


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