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Related Experiment Videos

Using administrative data to improve compliance with mandatory state event reporting.

Deborah Tuttle1, Robert J Panzer, Tracy Baird

  • 1Strong Memorial Hospital, Box 612, Rochester, NY 14642, USA. Deborah_Tuttle@URMC.Rochester.edu

The Joint Commission Journal on Quality Improvement
|June 18, 2002
PubMed
Summary

This study used ICD-9-CM codes to identify unreported adverse events in New York hospitals. Retrospective review successfully uncovered previously missed patient safety incidents, improving reporting accuracy.

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Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety
  • Medical Informatics

Background:

  • The New York Patient Occurrence and Tracking System (NYPORTS) is a mandatory adverse event reporting system.
  • Significant regional and hospital variations in reporting frequency were observed, unrelated to case mix.
  • Hospitals were mandated to conduct retrospective reviews for previously unreported adverse incidents.

Purpose of the Study:

  • To evaluate the effectiveness of using ICD-9-CM codes for retrospective identification of unreported adverse events.
  • To improve the accuracy and completeness of adverse event reporting in New York hospitals.
  • To enhance institutional awareness of mandatory reporting requirements.

Main Methods:

  • Matched NYPORTS categories with inpatient ICD-9-CM diagnosis and procedure codes.

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  • Analyzed variables including discharge disposition, coding position, readmissions, and exclusions.
  • Utilized ICD-9-CM analysis to screen over 60,000 discharges for potential NYPORTS cases.

    • Main Results:

    • 5,500 records were identified for review; 211 were already reported.
    • 13 NYPORTS codes showed a match rate of 30% or higher with ICD-9-CM codes (average 56% hit rate).
    • Retrospective review identified 187 reportable events (33.4%) for the screening code and 26 additional events for other codes; procedure-related occurrences yielded the most.

    Conclusions:

    • Retrospective review using ICD-9-CM codes effectively identified previously unreported adverse events.
    • The initiative increased hospital awareness of mandatory reporting processes.
    • The study stimulated redesigns in concurrent detection processes for improved patient safety.