Association between patient safety indicators and clinical outcomes at Cardio-thoracic Surgery Hospital.

Abstract

Background: Patient Safety Indicators (PSIs) were developed as a tool for hospitals to identify potentially preventable complications and improve patient safety performance. Aim: to measure the association between the patient safety indicator developed by Agency for Healthcare Research and Quality (AHRQ) - Perioperative hemorrhage or hematoma (POH) and clinical outcome including death, readmission within 30 days and length of stay at the cardiothoracic surgery hospital Ain Shams University. Method: A prospective cohort study was conducted surveying patients from admission till 1 month after discharge at the cardiothoracic surgery hospital who fulfills the inclusion criteria (Surgical admission for patients aged 18 years and older). The demographic, hospitalization and clinical outcome data were collected for 330 patients through basic information sheet and follow-up sheet. Results: the incidence rate of perioperative hemorrhage (POH) was 49.54 per 1000 discharges. Demographic data was not significantly associated with increased incidence of POH. The risk of development of POH was significantly higher in patients admitted directly to ICU [relative risk (RR) =5.6]. The risk of death and readmission was higher in cases who developed POH than those who did not [RR = 2.40 (0.60-9.55) and 2.43 (0.636 - 9.48) respectively]. Conclusion: Incidence rate of POH is relatively high. The incidence rate is higher in male patients. Patients who developed POH were at high risk for readmission and death. Recommendations: the hospital administration should consider strategies and policies to decrease the rate of POH and PSI9 and subsequent unfavorable clinical outcomes