Patient Safety Metrics Monitoring Across Harvard-Affiliated Hospitals: A Mixed Methods Study.

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Health Policy Analysis

Background:

• The proliferation of patient safety metrics over the last two decades has not led to standardized selection or monitoring practices.
• Understanding the variability in healthcare organizations' choice and monitoring of patient safety metrics is crucial.

Purpose of the Study:

• To catalog patient safety metrics chosen by healthcare organizations.
• To assess the active monitoring of these chosen metrics.
• To identify factors influencing the monitoring of patient safety metrics.

Main Methods:

• Surveys and in-depth interviews were conducted with patient safety experts from 11 Harvard-affiliated organizations.
• The study cataloged chosen metrics and their active monitoring status.
• Statistical analysis, including kappa statistics, was used to assess agreement on metric selection.

Main Results:

• Significant variability was observed in the active monitoring of patient safety metrics across different sites.
• Agreement on metric selection was weak (κ = 0.40), with notable variation by safety domain.
• Perceived usefulness, measurement burden, external mandates, and institutional commitments influenced monitoring decisions.

Conclusions:

• Despite considerable variability in metric selection, common decision-making themes exist among healthcare organizations.
• Findings provide guidance for health policymakers in designing and mandating effective patient safety metrics.