Patient Safety: The Baker Study

Patient Safety: The Baker Study Tuesday, March 20, 2012 Victoria Aceti Lecture 15 with Student-led Discussion

What is Patient Safety? • The Baker Study • Methodology • Results • Limitations • How health informatics can help (Kaushal Study) • Student-led Discussion Agenda Patient Safety

“the reduction and mitigation of unsafe acts within the health care system, as well as through the use of best practices shown to lead to optimal patient outcomes” (CIHI, 2007) INDICATORS OF PATIENT SAFETY: Adverse events Rate of infection Mortality trends Prevention practices Patient Safety Patient Safety

Group of researchers headed by Baker • There was little evidence of how safe patients were in Canadian acute care centres • Baker and colleagues looked specifically at adverse events as an indicator of patient safety • Government of Canada funded Canada Patient Safety Institute $50million over 5 years • Aimed to identify the type and frequency with which adverse events occur in Canadian acute care facilities The Baker Study Patient Safety

Harvard Medical School Methodology (1984) • 4 hospitals in 5 provinces (BC, AB, ON, PQ, NS) – randomly selected patient charts • 2 stage chart review process and 18 listed inclusion criteria • Reviewed by medical professionals • Data analysis The Baker Study: Methodology Patient Safety

7.5% of hospital admissions resulted in adverse events, 37% of which could have been preventable. • Adverse events tended to happen more frequently in teaching hospitals than small or community hospitals • Adverse events occurred more frequently with surgical patients • Adverse events occurred more frequently with older patients • Most patients recovered from reaction within 6 months The Baker Study: Results Patient Safety

Budget constraints limited scope of study • Looked only at adult populations • Excluded obstetrics and psychiatry • Human subjectivity of medical reviewers and not on a scale (length of stay & prevention) Future Research: • other health environments • more sites included in study The Baker Study: Limitations & Future Research Patient Safety

Baker: Suggested that electronic medical records would assist in future studies and in the development of quality improvement studies • Legibility of medication orders • Computerized order entry (reminders and alerts) • Automated drug administration (bar codes & “smart” IVs) Kaushal Study:Role of Health Informatics Patient Safety

Patient Safety: The Baker Study