International Journal for Quality in Health Care Advance Access originally published online on September 7, 2006
International Journal for Quality in Health Care 2006 18(5):325-326; doi:10.1093/intqhc/mzl041
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Editorial |
In terms of safety
Have your say on a new international approach to classifying patient safety information.Better classification of health information is often seen as a long way removed from the real work of making patient care safer. This is a mistaken view. Global progress on patient safety requires clear agreement about key safety terms and concepts. To date, a truly international patient safety classification has been missing. Our ability to accurately compare safety-related information across reporting and data collection systems is almost non-existent. This is a significant barrier to progress because many of the risks to patient safety are common across countries.
The vision of the World Alliance for Patient Safety is simple. Can we more systematically and quickly learn from the experiences of patient harm internationally to prevent future patients being harmed throughout the world [1]?
In more and more organizations worldwide, we have seen a growing interest in encouraging health care workers to voluntarily report information about events that harm patients or have that potential [2]. Such developments have given rise to many safety-related taxonomies designed to organize and categorize data about patient safety problems so that they can be analyzed more systematically. This is a welcome development. Reporting is only of value if it leads to a constructive response [2].
However, this has led to a myriad of patient safety taxonomies in use in various countries, each designed for a specific purpose [3]. For all intents and purposes, each of these meets the requirements for which they are designed. Although each has elements of potential interest to all, none on its own is fit for the purpose of an international approach to classifying patient safety data.
Faced with this gap in late 2005, the WHO World Alliance for Patient Safety initiated work on an International Patient Safety Event Classification (IPSEC). It aims to define, harmonize, and group patient safety concepts into an internationally agreed classification in a way that is conducive to learning and improving patient safety across systems. It is intended that the classification will be adaptable yet consistent across the entire spectrum of health care and across cultures and languages [4]. It will link closely with the WHO Family of International Classifications and the WHO Drug Dictionary.
IPSEC draws on the work of the US Joint Commission on Accreditation of Healthcare Organizations’ Patient Safety Event Taxonomy, as well as the National Reporting and Learning System in England, the Advanced Information Management System in Australia, and the Eindhoven Classification Model from the Netherlands [5–8].
As an important part of ensuring relevance and building international consensus, the World Alliance is embarking upon a Delphi Survey on the IPSEC. This is designed to ensure the widest possible feedback and input on the proposed conceptual framework, concepts, and terms. This web-based process will commence in late August 2006. Practitioners and other experts interested in patient safety are invited to join the survey community and to have their voice heard. It is vital that we get wide-ranging input through this Delphi process.
In developing the IPSEC, the World Alliance has been guided by a small drafting group made up of individuals with expertise in patient safety, information management, and classification [4]. The guidance of the drafting group has been invaluable in ensuring that the IPSEC meets high standards of technical excellence. However, the scientific soundness of the IPSEC is a necessary but not sufficient requirement for success. The World Alliance is keen to ensure an approach that meets the needs of as many WHO Member States as possible. This is no small challenge given the diversity of health systems and patient safety issues around the world.
Because of the feedback received through the Delphi Survey, the IPSEC will be further revised with a view to commencing field testing in 2007. It is planned that the finalized version of the IPSEC will be available by early 2008.
To access the Delphi survey, visit www.who-ipsec.org
WHO, World Alliance for Patient Safety, Geneva, Switzerland
References
- Donaldson L. When will health care pass the orange-wire test? Lancet 2004; 364: 1567–1568.[CrossRef][Medline]
- World Health Organization. Draft Guidelines on Adverse Event Reporting and Learning Systems. Geneva: World Health Organization, 2005.[CrossRef][Medline]
- World Health Organization. Project to develop the international patient safety event taxonomy: updated review of the literature 2003–2005: http://www.who.int/entity/patientsafety/taxonomy/IPSET_Sept05_FINAL.pdf Accessed 4 August 2006.
- World Health Organization. Project to develop the international patient safety event taxonomy report of the WHO World Alliance for Patient Safety drafting group 24–25 October 2005 Vancouver final report: http://www.who.int/entity/patientsafety/taxonomy/Final_Report_of_Drafting_Group05.pdf Accessed 4 August 2006.
- Chang A, Schyve PM, Croteau RJ, O’Leary DS, Loeb JM. The JCAHO patient safety event taxonomy: a standardized terminology and classification schema for near misses and adverse events. Int J Qual Health Care 2005; 17: 95–105.
[Abstract/Free Full Text] - The National Reporting and Learning System – National Health Service, National Patient Safety Agency: http://www.npsa.nhs.uk/health/display?contentId=2389 Accessed 4 August 2006.
[Abstract/Free Full Text] - The Australian Incident Monitoring System – Australian Patient Safety Foundation: http://www.apsf.net.au Accessed 4 August 2006.
- The Eindhoven Classification Model for System Failure (ECM) and the Prevention and Recovery Information System for Monitoring and Analysis – Medical (PRISMA). Eindhoven, The Netherlands: Eindhoven University of Technology, August 2005.
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