Patient safety

Development of patient safety indicators for data-poor hospitals


Patient safety indicators measure factors contributing to adverse events. Data-poor hospitals (DPH) are those hospitals which:

  • Do not routinely have available information about patient characteristics (characteristics of the patient, the diagnosis, and co-morbidity) and the process of care delivery, and/or;
  • The patient based clinical data sources are not considered accessible and/or reliable, and/or;
  • Lack the resources to set up reliable and accessible patient based clinical information systems.

This project started in 2008 with a discussion on the basic conceptual framework for patient safety assessment and on possible roadmaps for the development of measures. An expert meeting in November 2008 explored potential dimensions for measurement, producing a first tentative list which includes clinical outcomes-based factors, as well as process structure-based factors such as governance, environment, patient-centredness, information and workforce.

During 2009 and 2010 this work has been further developed and consensus has been reached by means of a Delphi like exercise with an international group of experts on the dimensions and candidate measures that could be recommended for testing.

Development process

The indicators will be developed using a four-stage process:

  • Selecting the relevant patient safety outcomes or patient safety issues.
  • Identifying the essential contributing factors for each of the relevant patient safety issues.
  • Selecting the specific recommendations and indicators.
  • Reporting.