PMID- 29602858
OWN - NLM
STAT- MEDLINE
DCOM- 20190304
LR  - 20190304
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 8
IP  - 3
DP  - 2018 Mar 30
TI  - Incidence of adverse events in Sweden during 2013-2016: a cohort study describing 
      the implementation of a national trigger tool.
PG  - e020833
LID - 10.1136/bmjopen-2017-020833 [doi]
LID - e020833
AB  - OBJECTIVES: To describe the implementation of a trigger tool in Sweden and 
      present the national incidence of adverse events (AEs) over a 4-year period 
      during which an ongoing national patient safety initiative was terminated. 
      DESIGN: Cohort study using retrospective record review based on a trigger tool 
      methodology. SETTING AND PARTICIPANTS: Patients >/=18 years admitted to all somatic 
      acute care hospitals in Sweden from 2013 to 2016 were randomised into the study. 
      PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measure was the incidence 
      of AEs, and secondary measures were type of injury, severity of harm, 
      preventability of AEs, estimated healthcare cost of AEs and incidence of AEs in 
      patients cared for in another type of unit than the one specialised for their 
      medical needs ('off-site'). RESULTS: In a review of 64 917 admissions, the 
      average AE rates in 2014 (11.6%), 2015 (10.9%) and 2016 (11.4%) were 
      significantly lower than in 2013 (13.1%). The decrease in the AE rates was seen 
      in different age groups, in both genders and for preventable and non-preventable 
      AEs. The decrease comprised only the least severe AEs. The types of AEs that 
      decreased were hospital-acquired infections, urinary bladder distention and 
      compromised vital signs. Patients cared for 'off-site' had 84% more preventable 
      AEs than patients cared for in the appropriate units. The cost of increased 
      length of stay associated with preventable AEs corresponded to 13%-14% of the 
      total cost of somatic hospital care in Sweden. CONCLUSIONS: The rate of AEs in 
      Swedish somatic hospitals has decreased from 2013 to 2016. Retrospective record 
      review can be used to monitor patient safety over time, to assess the effects of 
      national patient safety interventions and analyse challenges to patient safety 
      such as the increasing care of patients 'off-site'. It was found that the 
      economic burden of preventable AEs is high.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Nilsson, Lena
AU  - Nilsson L
AD  - Department of Medical and Health Sciences, Linkoping University, Linkoping, 
      Sweden.
AD  - Department of Anesthesiologyand Intensive Care, University Hospital, Linkoping, 
      Sweden.
FAU - Borgstedt-Risberg, Madeleine
AU  - Borgstedt-Risberg M
AD  - Centre for Organisational Support and Development (CVU), Linkoping University, 
      Linkoping, Sweden.
FAU - Soop, Michael
AU  - Soop M
AD  - National Board of Health and Welfare, Stockholm, Sweden.
FAU - Nylen, Urban
AU  - Nylen U
AD  - National Board of Health and Welfare, Stockholm, Sweden.
FAU - Alenius, Carina
AU  - Alenius C
AD  - Swedish Association of Local Authorities and Regions, Stockholm, Sweden.
FAU - Rutberg, Hans
AU  - Rutberg H
AD  - Swedish Association of Local Authorities and Regions, Stockholm, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180330
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - *Medical Errors/statistics & numerical data
MH  - Medical Records
MH  - Middle Aged
MH  - *Patient Safety
MH  - *Quality Indicators, Health Care
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Safety Management
MH  - Sweden
MH  - Young Adult
PMC - PMC5884347
OTO - NOTNLM
OT  - adverse event
OT  - patient harm
OT  - patient safety
OT  - trigger tool
COIS- Competing interests: None declared.
EDAT- 2018/04/01 06:00
MHDA- 2019/03/05 06:00
PMCR- 2018/03/30
CRDT- 2018/04/01 06:00
PHST- 2018/04/01 06:00 [entrez]
PHST- 2018/04/01 06:00 [pubmed]
PHST- 2019/03/05 06:00 [medline]
PHST- 2018/03/30 00:00 [pmc-release]
AID - bmjopen-2017-020833 [pii]
AID - 10.1136/bmjopen-2017-020833 [doi]
PST - epublish
SO  - BMJ Open. 2018 Mar 30;8(3):e020833. doi: 10.1136/bmjopen-2017-020833.