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This
demonstration project focuses
on medical adverse events in
80 acute care hospitals in Utah
and Missouri by examining existing
hospital discharge data reporting
systems, producing quarterly
reports on adverse events for
hospitals, and by conducting
regulatory licensure intervention
in Missouri and educational
intervention in Utah.
Utah and Missouri's health departments
have statutory authority to
collect electronic individual
discharge records from all licensed
healthcare facilities and to
disseminate analytical results
to the facilities and the public
in these two states. The states
use the administrative data
to monitor population morbidity
and healthcare issues such as
access, quality, and cost. This
study proposes to expand the
use of the hospital discharge
data system to include patient
safety improvement. In Utah
the project will focus on adverse
drug events (ADEs).
New
classifications of ICD-9-CM N-codes
and E-codes on adverse events and complications
of care will be used to analyze the
available hospital discharge data. Hospital
medical chart review will attempt to
answer the following questions:
· Can the hospital
discharge data be used for detecting
hospital adverse events?
· What proportion
of adverse events identified by ICD-9-CM
codes occurred prior to hospital admission?
· What proportion
of adverse events that occurred in hospitals
was not captured in hospital discharge
data?
· What coding improvements
for patient safety can be made?
In
addition, structured interviews and
hospital management processes surveys
will be conducted. The results from
these qualitative and quantitative researches
will be applied in the proposed interventions.
Currently
42 states in the U.S. have hospital
discharge data systems in place. This
study's findings and recommendations
will provide valuable information and
lessons learned for other states to
assist hospitals with developing a public
health information system on patient
safety.
This
project is supported by grant number
U18HS11885 from the Agency for Healthcare
Research and Quality and under the guidance
of the Utah/Missouri Patient Safety
Consortium. The Consortium includes
the following members:
Utah
Department of Health
HealthInsight
UHA, Utah Hospitals and Health Systems
Association
University of Utah, Department of Medical
Informatics
LDS Hospital, Intermountain Health Care
Missouri Department of Health and Senior
Services
Missouri Patient Care Review Foundation
University
of Missouri-Columbia School of Medicine
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