Patient Safety Research
Measuring the impact of interventions
Interventions to improve patient safety aim at diminishing the number of harmful incidents that take place during the process of care. To date, the classical methods for measuring harm have relied on medical records and have generally been used in developed countries, where good medical information systems are available.
Appropriate methods for data-poor settings had not been identified up to now even though these are essential to assessing patient safety improvements.
WHO Patient Safety has led work over the past five years, whose aim is the development and piloting of methods that permit the measurement of harm in the absence of good medical records, or for settings where the resources needed for medical records review are limited. Led by Dr Philippe Michel, a team of researchers has developed and tested the methodology in five countries, Jordan, Kenya, Peru, Thailand and Tunisia. These methods are described in the recently published report Assessing and tackling patient harm: A methodological guide for data poor hospitals . This document provides guidance on choosing the most appropriate methods for assessing patient safety, depending on the objectives and available resources, offers protocols describing how to conduct the methods and supplies the tools needed to implement these.
The guide describes five different methods. Three of these involve counting the occurrence of harmful incidents (or adverse events). Another method describes how to conduct a nominal group technique to gather experiences from health professionals and set priorities for action. The fifth method describes how to observe whether specific procedures are conducted in an appropriate manner.
The guide is particularly adapted for assessing and tackling patient harm in data-poor hospitals, but can also be used in developed countries or in non-hospital settings.
We hope that this document will assist health-care providers and researchers around the world with assessing their local patient safety issues and assessing the impact of interventions they might currently be implementing.
Feedback on this report is gratefully received at research@who.int.