PMID- 28320797
OWN - NLM
STAT- MEDLINE
DCOM- 20171226
LR  - 20190202
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 7
IP  - 3
DP  - 2017 Mar 20
TI  - Design and reliability of a specific instrument to evaluate patient safety for 
      patients with acute myocardial infarction treated in a predefined care track: a 
      retrospective patient record review study in a single tertiary hospital in the 
      Netherlands.
PG  - e014360
LID - 10.1136/bmjopen-2016-014360 [doi]
LID - e014360
AB  - OBJECTIVE: Numerous studies have shown that a substantial number of patients 
      suffer from adverse events (AEs) as a result of hospital care. However, specific 
      data on AEs in acute cardiac care are scarce. The current manuscript describes 
      the development and validation of a specific instrument to evaluate patient 
      safety of a predefined care track for patients with acute myocardial infarction 
      (AMI). DESIGN: Retrospective patient record review study. SETTING AND 
      PARTICIPANTS: A total of 879 hospital admissions treated in a tertiary care 
      centre for an AMI (age 64+/-12 years, 71% male). MAIN OUTCOME MEASURE: In the first 
      phase, the medical records of patients with AMI warranting coronary angiography 
      or coronary intervention were analysed for process deviations. In the second 
      phase, the medical records of these patients were checked for any harm that had 
      occurred which was caused by the healthcare provider or the healthcare 
      organisation (AE) and whether the harm that occurred was preventable. RESULTS: Of 
      all 879 patients included in the analysis, 40% (n=354) had 1 or more process 
      deviation. Of these 354 patients, 116 (33%) had an AE. Patients with AE 
      experienced more process deviations compared with patients without AE (2+/-1.7 vs 
      1.5+/-0.9 process deviations per patient, p=0.005). Inter-rater reliability in 
      assessing a causal relation of healthcare with the origin of an AE showed a kappa of 
      0.67 (95% CI 0.51 to 0.83). CONCLUSIONS: This study shows that it is possible to 
      develop a reliable method, which can objectively assess process deviations and 
      the occurrence of AEs in a specified population. This method could be a starting 
      point for developing an electronic tracking system for continuous monitoring in 
      strictly predefined care tracks.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/.
FAU - Eindhoven, Danielle C
AU  - Eindhoven DC
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Borleffs, C Jan Willem
AU  - Borleffs CJ
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Dietz, Marlieke F
AU  - Dietz MF
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Schalij, Martin J
AU  - Schalij MJ
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Brouwers, Corline
AU  - Brouwers C
AD  - Department of Public and Occupational Health, EMGO Institute for Health and Care 
      Research, VU University Medical Center, Amsterdam, The Netherlands.
FAU - de Bruijne, Martine C
AU  - de Bruijne MC
AD  - Department of Public and Occupational Health, EMGO Institute for Health and Care 
      Research, VU University Medical Center, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20170320
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical Errors/*prevention & control
MH  - Medical Records/*statistics & numerical data
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - Netherlands
MH  - Patient Safety/*statistics & numerical data
MH  - Reproducibility of Results
MH  - *Research Design
MH  - Retrospective Studies
MH  - *Tertiary Care Centers
PMC - PMC5372110
OTO - NOTNLM
OT  - Medical Error
OT  - Patient Harm
OT  - Patient Safety
OT  - Process Assessment
COIS- Competing interests: None declared.
EDAT- 2017/03/23 06:00
MHDA- 2017/12/27 06:00
PMCR- 2017/03/20
CRDT- 2017/03/22 06:00
PHST- 2017/03/22 06:00 [entrez]
PHST- 2017/03/23 06:00 [pubmed]
PHST- 2017/12/27 06:00 [medline]
PHST- 2017/03/20 00:00 [pmc-release]
AID - bmjopen-2016-014360 [pii]
AID - 10.1136/bmjopen-2016-014360 [doi]
PST - epublish
SO  - BMJ Open. 2017 Mar 20;7(3):e014360. doi: 10.1136/bmjopen-2016-014360.