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Related Experiment Video

Updated: Dec 12, 2025

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
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Expert Consensus on Currently Accepted Measures of Harm.

Merranda S Logan, Laura C Myers, Hojjat Salmasian

  • 1Risk Management Foundation of the Harvard Medical Institutions (CRICO).

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|August 10, 2020
PubMed
Summary

Experts used the World Café method to identify key health care adverse event triggers and measures for chart review. This approach prioritized clinically important indicators for assessing patient harm in both inpatient and outpatient settings.

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Area of Science:

  • Health Services Research
  • Patient Safety
  • Medical Quality Improvement

Background:

  • The landscape of healthcare-associated harm has evolved significantly since the Harvard Medical Practice Study.
  • Contemporary adverse event identification requires updated measures and triggers.
  • Existing methods for tracking patient harm need refinement.

Purpose of the Study:

  • To generate a contemporary list of triggers and adverse event measures for chart review.
  • To determine the current incidence of inpatient and outpatient adverse events.
  • To establish expert consensus on the clinical importance and suitability of these measures.

Main Methods:

  • A modified World Café event was conducted in March 2018.
  • Seventy-one content experts from diverse institutions participated.
  • Experts rated literature-based triggers and measures on clinical importance and suitability for chart review and electronic extraction.

Main Results:

  • 67% of measures and 46% of triggers were deemed highly clinically important.
  • 218 triggers/measures were highly amenable to chart review.
  • 198 triggers/measures were suitable for electronic surveillance.

Conclusions:

  • The World Café method successfully prioritized clinically important measures and triggers.
  • Prioritized measures are suitable for chart review, the current gold standard.
  • Future validation using electronic surveillance is planned to reduce reliance on chart review.