Estimating the Frequency of Inpatient Adverse Events Using a 2-Step Retrospective Chart Review: Initial Observational...

Area of Science:

• Healthcare Quality and Safety
• Global Health
• Medical Informatics

Background:

• Lower- and middle-income countries face a high burden of adverse healthcare events.
• Patient safety research is concentrated in high-income nations, limiting applicability in resource-limited settings.

Purpose of the Study:

• To identify the optimal methodology for detecting inpatient adverse events in a lower- to middle-income country tertiary care hospital.
• To adapt the selected methodology based on pilot study experiences for future large-scale implementation.

Main Methods:

• A 2-step retrospective chart review was employed.
• Two screening tools (1A and 1B) were compared for effectiveness.
• 100 patient records from 2019 were analyzed to determine the adverse event rate per 100 admissions.

Main Results:

• Tool 1A identified 1 adverse event per 100 admissions.
• Tool 1B identified 30 adverse events per 100 admissions, with 60% deemed preventable.
• Tool 1B demonstrated higher sensitivity in detecting adverse events.

Conclusions:

• Tool 1B, adapted from the Global Trigger Tool, is a suitable and sensitive method for identifying adverse events in lower- to middle-income countries.
• Pilot study findings informed improvements for a full-scale patient safety study.