Increasing the options for reducing adverse events: Results from a modified Delphi technique

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Medical Error Reduction Strategies

Background:

• The landmark 1995 'Quality in Australian Health Care' study highlighted significant adverse events in hospitals.
• Despite identified issues, a comprehensive strategy for reducing adverse events was not fully implemented.
• This study revisits potential solutions that were available but not adopted.

Purpose of the Study:

• To propose a method for expanding options to reduce adverse events in Australian hospitals.
• To identify specific suggestions for adverse event reduction.
• To estimate the time lag for these suggestions to impact mortality and morbidity.

Main Methods:

• A modified Delphi technique was employed, involving an expert panel.
• The panel, selected for expertise in adverse events and quality assurance, initially proposed options.
• Suggestions were collated and returned to the panel for refinement and feedback.

Main Results:

• Responses were received from 20 of the 20 initially approached experts.
• Forty-one distinct options for reducing adverse events (AEs) were identified.
• The average estimated time for impact was 3.5 years, with hospital regulation being fastest (2.4 years) and out-of-hospital information slowest (6.4 years).

Conclusions:

• A more rapid and extensive response to adverse events was feasible after the 1995 study.
• Effective strategies for reducing adverse events and associated patient harm were available.
• These potentially life-saving options remain underutilized in Australian healthcare settings.