Rates Of Patient Safety Indicators In Belgian Hospitals Were Low But Generally Higher Than In US Hospitals, 2016-18

Area of Science:

• Healthcare Quality and Safety
• Hospital Performance Measurement
• Patient Outcomes Research

Background:

• Patient Safety Indicators (PSIs) were developed by the Agency for Healthcare Research and Quality over 20 years ago to monitor severe adverse events.
• The relevance and current applicability of PSIs in European healthcare settings remain uncertain, with a lack of recent data on overall rates and interhospital variability.
• Previous exploration of PSI application outside the US occurred over a decade ago.

Purpose of the Study:

• To assess the nationwide occurrence and variability of thirteen adverse events using Patient Safety Indicators in Belgium.
• To provide an up-to-date evaluation of PSI-associated adverse event rates and their distribution across Belgian hospitals.
• To identify specific PSIs that may require focused quality improvement efforts.

Main Methods:

• A nationwide retrospective study analyzing 4,765,850 patient stays across all 101 Belgian hospitals between 2016 and 2018.
• Calculation of adverse event rates for thirteen selected Patient Safety Indicators.
• Analysis of interhospital variability in adverse event rates.

Main Results:

• Adverse event rates were generally low: 0.1% for medical stays and 1.2% for surgical stays.
• Belgian adverse event rates were higher compared to equivalent US rates.
• Considerable between-hospital variability was observed, with some hospitals showing significantly higher rates for specific PSIs (e.g., failure-to-rescue at 23%, central line-associated bloodstream infections up to 8 times the national rate).

Conclusions:

• Patient Safety Indicators reveal generally low but notable adverse event rates in Belgian hospitals, exceeding US benchmarks.
• Significant interhospital variability in PSI rates suggests opportunities for targeted quality improvement initiatives.
• Focusing on PSIs with high event rates or substantial variability, such as failure to rescue and central line-associated bloodstream infections, can enhance care quality in Belgian hospitals.