PMID- 21227956
OWN - NLM
STAT- MEDLINE
DCOM- 20110818
LR  - 20220316
IS  - 1464-3677 (Electronic)
IS  - 1353-4505 (Linking)
VI  - 23
IP  - 2
DP  - 2011 Apr
TI  - Variation in the rates of adverse events between hospitals and hospital 
      departments.
PG  - 126-33
LID - 10.1093/intqhc/mzq086 [doi]
AB  - OBJECTIVE: The objective of this study was to analyze the variation in the rates 
      of adverse events (AEs), and preventable AEs, between hospitals and hospital 
      departments in order to investigate the room for improvement in reducing AEs at 
      both levels. In addition, we explored the extent to which patient, department and 
      hospital characteristics explain differences in the rates of AEs. DESIGN: 
      Structured retrospective patient record review of hospital admissions. SETTING: 
      Twenty-one Dutch hospitals. Population A representative random sample of 7113 
      hospital admissions in 2004. MAIN OUTCOME MEASURES: Variation in AEs, and 
      preventable AEs, between hospitals and hospital departments and the explanatory 
      factors of the variation. RESULTS: The rates of AEs varied between hospitals (P = 
      0.05) and hospital departments (P < 0.05). The rates of preventable AEs only 
      varied significantly between hospital departments. The clustering of preventable 
      AEs in hospital departments was more than twice that found in hospitals (ICC 9.5 
      versus 3.5%). The type of hospital explained 35% of the inter-hospital variance 
      in AEs. Patient and department characteristics explained 23% of the 
      inter-department variance in preventable AEs. CONCLUSIONS: In addition to 
      interventions to improve the overall patient safety within a hospital, 
      interventions tailored for specific departments are necessary to reduce their 
      patient safety risks. Monitoring and comparing the performance of hospitals 
      should not be limited to the hospital level, but should be extended to the 
      individual department since there can be significant differences in the rates of 
      preventable AEs between different departments within the same hospital.
FAU - Zegers, Marieke
AU  - Zegers M
AD  - NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN 
      Utrecht, The Netherlands. m.zegers@iq.umcn.nl
FAU - De Bruijne, Martine C
AU  - De Bruijne MC
FAU - Spreeuwenberg, Peter
AU  - Spreeuwenberg P
FAU - Wagner, Cordula
AU  - Wagner C
FAU - Van Der Wal, Gerrit
AU  - Van Der Wal G
FAU - Groenewegen, Peter P
AU  - Groenewegen PP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110111
PL  - England
TA  - Int J Qual Health Care
JT  - International journal for quality in health care : journal of the International 
      Society for Quality in Health Care
JID - 9434628
SB  - IM
MH  - Diagnosis-Related Groups/statistics & numerical data
MH  - Female
MH  - Hospital Departments/*statistics & numerical data
MH  - Hospital Mortality
MH  - Hospitals/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Medical Errors/*statistics & numerical data
MH  - Medical Records/statistics & numerical data
MH  - Multilevel Analysis
MH  - Netherlands/epidemiology
MH  - Outcome Assessment, Health Care/statistics & numerical data
MH  - Retrospective Studies
MH  - Safety/standards/statistics & numerical data
EDAT- 2011/01/14 06:00
MHDA- 2011/08/19 06:00
CRDT- 2011/01/14 06:00
PHST- 2011/01/14 06:00 [entrez]
PHST- 2011/01/14 06:00 [pubmed]
PHST- 2011/08/19 06:00 [medline]
AID - mzq086 [pii]
AID - 10.1093/intqhc/mzq086 [doi]
PST - ppublish
SO  - Int J Qual Health Care. 2011 Apr;23(2):126-33. doi: 10.1093/intqhc/mzq086. Epub 
      2011 Jan 11.