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Variability in Serious Safety Event Classification among Children's Hospitals: A Measure for Comparison?
Amy Poppy1, Sonja I Ziniel2, Daniel Hyman3
1From the Children's Hospital Colorado, Division of Quality and Patient Safety, Aurora, Colorado.
Pediatric Quality & Safety
|April 8, 2024
Summary
A pediatric hospital safety collaborative found agreement in classifying serious safety events (SSEs), but variability exists. Caution is advised when comparing patient safety outcomes across hospitals using SSE rates.
Area of Science:
- Pediatric patient safety
- Healthcare quality improvement
- Medical error analysis
Background:
- Hospitals lack a standardized method for measuring and comparing rates of serious safety events (SSEs).
- A pediatric hospital safety collaborative developed a common definition and measurement system for SSEs.
- Evaluating the utility and consistency of this SSE measurement system is crucial.
Purpose of the Study:
- To assess the agreement among pediatric hospitals in classifying serious safety events (SSEs) using a standardized system.
- To evaluate the consistency of SSE classification across different healthcare institutions.
- To determine the reliability of using SSE rates for inter-hospital comparisons.
Main Methods:
- A web-based survey was distributed to 132 network hospitals.
- The survey included 7 case vignettes for respondents to classify as SSEs.
- Respondents used their organization's taxonomy for deviations and SSE classification.
Main Results:
- 82% of 82 respondents used the same SSE classification system.
- Substantial agreement was found for deviation classification in 3 out of 5 assessable vignettes.
- Substantial agreement was found for SSE classification in 4 out of 7 vignettes, with fair to moderate agreement in the remainder.
Conclusions:
- Agreement and variability exist in classifying deviations and SSEs among pediatric hospitals.
- While the SSE methodology yields generally similar review results, caution is needed.
- Using SSE rates to compare patient safety outcomes across hospitals requires careful consideration due to observed variability.
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