LR34 / Adverse events unifying methodology

Type of Patient Safety Practice
Clinical Practice (CP)
Related practices from PaSQ database
“Best fit” category of the reported practice


Medication / IV Fluids
Patient safety theme the SCP/clinical risk management practice is aimed at
The first step to reduce adverse events is to know with certainty when, how and why they occur.The methodology to identify and analyze adverse events in Medical Departments must be unifying. There is uniformity in the definition of adverse events and in the methodology applied to identify them. However, there is great variability in the time that elapses between the moment in which the adverse event is detected and the date on which it occurred. System resilience
Objective of the CRM practice
To determine the incidence reported in the medical literature of adverse events in medical departments.
Short description of the CRM practice, including any references for further information
They reviewed 17,437 entries. After reading the abstracts and articles, and applying previously defined inclusion and exclusion criteria, we selected 10 articles that reported the incidence of adverse events in medical departments. Most studies corresponded to a historical cohort, had used an AE screening to identify high risk patients, and had used a structured review to check clinical records. None of them had as their ultimate objective to report on the impact of adverse events or characterize them. The incidence reported in medical departments ranged from 3.6% to 21.7%. The definitions of adverse events and forms of detection were similar; however the few differences put the comparability at risk [3].
Innovator of the SCP, country of origin
This study was conducted in Spain. However, these articles revised studies published in English or Spanish from different countries.
Involved health care staff
Health professionals of Medical Departments
Tested in which countries/health care systems, health care context(s) and/or clinical specialty/specialties, including references
Medical departments studies reviewed from 2004 to 2010 [3].
Summary of evidence for effectiveness, including references
There is a scarcity of review studies about the frequency of adverse events (AE) in medical departments. A majority of the studies have been conducted on surgical departments while only a few on overall frequency of adverse events [1] [2]. This review yielded that no studies were aimed at quantifying or characterising the adverse events in healthcare. None of them defined what constitutes a medical department, although the results reported are within the published values for health systems. Further research is needed in this area [3].
Summary of evidence for transferability (transferability across health care systems or health care contexts or clinical specialties), including references
There is no specified text here
Summary of available information on feasibility, including references
There is no information avaialble regarding feasibility
Existing implementation tools, including references
None described
Potential for/description of patient involvement in the CRM practice, including references
None described
Bibliography (for each reference: author(s), year, title, journal/internet link, page(s))
[1] Aranaz J, Aibar C, Gea M, León M. Efectos adversos en la asistencia hospitalaria, Una revisión crítica. Med Clin (Barc). 2004;123:21-5
[2] De Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care. 2008;17:216-23.
[3] R. Poblete Umanzor, S. Conejeros Fritz, M.J. Corrales Fernández, J.J. Miralles Bueno and J. Aranaz Andrés. Systematic literature review on patient safety in medical departments. Rev Calid Asist. 2011;26(6):359-366.
Prof. Jose Mira, Julián Vitaller and Jesús Aranaz. Universidad Miguel Hernandez
Universidad Miguel Hernandez
Any additional information on the CRM (e.g. implementation barriers and drivers)