Evidence map›Paper›PMID 24270831›Full record

ArticleBMJ open2013

The orthopaedic error index: development and application of a novel national indicator for assessing the relative safety of hospital care using a cross-sectional approach.

Sukhmeet S Panesar, Gopalakrishnan Netuveli, Andrew Carson-Stevens, Sundas Javad, Bhavesh Patel, Gareth Parry, Liam J Donaldson, Aziz Sheikh

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Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Sukhmeet S PanesarDepartment of Public Health, London Borough of Richmond Upon Thames, Richmond, UK.
Gopalakrishnan Netuveli
Andrew Carson-Stevens
Sundas Javad
Bhavesh Patel
Gareth Parry
Liam J Donaldson
Aziz Sheikh

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe Orthopaedic Error Index for hospitals aims to provide the first national assessment of the relative safety of provision of orthopaedic surgery.

designCross-sectional study (retrospective analysis of records in a database).

settingThe National Reporting and Learning System is the largest national repository of patient-safety incidents in the world with over eight million error reports. It offers a unique opportunity to develop novel approaches to enhancing patient safety, including investigating the relative safety of different healthcare providers and specialties.

participantsWe extracted all orthopaedic error reports from the system over 1 year (2009-2010). OUTCOME MEASURES: The Orthopaedic Error Index was calculated as a sum of the error propensity and severity. All relevant hospitals offering orthopaedic surgery in England were then ranked by this metric to identify possible outliers that warrant further attention.

results155 hospitals reported 48 971 orthopaedic-related patient-safety incidents. The mean Orthopaedic Error Index was 7.09/year (SD 2.72); five hospitals were identified as outliers. Three of these units were specialist tertiary hospitals carrying out complex surgery; the remaining two outlier hospitals had unusually high Orthopaedic Error Indexes: mean 14.46 (SD 0.29) and 15.29 (SD 0.51), respectively.

conclusionsThe Orthopaedic Error Index has enabled identification of hospitals that may be putting patients at disproportionate risk of orthopaedic-related iatrogenic harm and which therefore warrant further investigation. It provides the prototype of a summary index of harm to enable surveillance of unsafe care over time across institutions. Further validation and scrutiny of the method will be required to assess its potential to be extended to other hospital specialties in the UK and also internationally to other health systems that have comparable national databases of patient-safety incidents.

Indexed as

ORTHOPAEDIC & TRAUMA SURGERYPUBLIC HEALTH

Identifiers

PMID24270831
PMCPMC3840344

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