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Adverse events in health care: issues in measurement

Dr K Walshe, senior research fellow, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Birmingham B15 2RT, UK Introduction

Adverse events—"instances which indicate or may indicate that a patient has received poor quality care"¹—are used widely in healthcare quality measurement and improvement activities. Many commonly employed quality improvement mechanisms, such as incident reporting, occurrence screening, significant event auditing, processes for dealing with complaints, and (in the UK) the national confidential enquiries into various areas of clinical care are essentially focused on such adverse events. Even traditional medical quality improvement mechanisms such as mortality and morbidity conferences or death and complications meetings are predicated on the idea that by identifying and examining adverse events, we can learn lessons and change practice in ways that will make such events less likely in future and hence improve the quality of health care.

The principle that studying adverse events can produce information which leads to quality improvements is far from new and has been much used outside of health care.^{2, 3} It has . . . [Full text of this article]

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