A pilot study on record reviewing with a priori patient selection

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Clinical Informatics

Background:

• Adverse events (AEs) are a significant concern in healthcare, impacting patient outcomes and increasing costs.
• Traditional methods for identifying AEs can be time-consuming and may miss critical cases.
• Developing efficient methods for AE detection is crucial for enhancing patient safety.

Purpose of the Study:

• To evaluate the effectiveness of using unexpectedly long length of stay (UL-LOS) as a primary selection criterion for identifying patient records with AEs.
• To compare the yield of AEs from UL-LOS records versus non-UL-LOS records in colorectal cancer patients.

Main Methods:

• A retrospective study was conducted at a medium-sized general hospital in The Netherlands.
• Patient records of 191 colorectal cancer patients were reviewed.
• Adverse events (AEs) and triggers were the primary outcome measures, comparing UL-LOS patients with a reference group.

Main Results:

• Records of colorectal cancer patients with UL-LOS showed a significantly higher incidence of AEs (51%) compared to non-UL-LOS patients (9%).
• Within the UL-LOS group, 84% of records with at least one trigger contained one or more AEs.
• This indicates a strong correlation between UL-LOS and the presence of adverse events.

Conclusions:

• A priori selection of patient records based on UL-LOS is a powerful and effective method for detecting AEs.
• This approach offers healthcare professionals a practical tool to identify patient safety improvement opportunities in daily practice.
• Implementing UL-LOS as a selection criterion can enhance the efficiency of AE surveillance and patient safety initiatives.