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Examining the Relationship of an All-Cause Harm Patient Safety Measure and Critical Performance Measures at the Frontline of Care

Sammer, Christine, DrPH, RN*; Hauck, Loran D., MD; Jones, Cason, MLS, MHA*; Zaiback-Aldinger, Julie, MPH; Li, Michael, PhD§; Classen, David, MD, MS∥¶

doi: 10.1097/PTS.0000000000000468
Original Article: PDF Only

Background In 2015, the Institute of Medicine Vital Signs report called for a new patient safety composite measure to lessen the reporting burden of patient harm. Before this report, two patient safety organizations had developed an electronic all-cause harm measurement system leveraging data from the electronic health record, which identified and grouped harms into five broad categories and consolidated them into one all-cause harm outcome measure.

Objectives The objective of this study was to examine the relationship between this all-cause harm patient safety measure and the following three performance measures important to overall hospital safety performance: safety culture, employee engagement, and patient experience.

Methods We studied the relationship between all-cause harm and three performance measures on eight inpatient care units at one hospital for 7 months.

Results The findings demonstrated strong correlations between an all-cause harm measure and patient safety culture, employee engagement, and patient experience at the hospital unit level. Four safety culture domains showed significant negative correlations with all-cause harm at a P value of 0.05 or less. Six employee engagement domains were significantly negatively correlated with all-cause harm at a P value of 0.01 or less, and six of the ten patient experience measures were significantly correlated with all-cause harm at a P value of 0.05 or less.

Conclusions The results show that there is a strong relationship between all-cause harm and these performance measures indicating that when there is a positive patient safety culture, a more engaged employee, and a more satisfying patient experience, there may be less all-cause harm.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

From the *Office of Clinical Effectiveness, Adventist Health System; †Chief Clinical Officer, Adventist Health System; ‡Advocacy and Public Policy, Adventist Health System, Altamonte Springs, Florida; §Applied Science, Pascal Metrics, Washington, District of Columbia; ∥University of Utah, Salt Lake City, Utah, and ¶Chief Medical Information Officer, Pascal Metrics, Washington, District of Columbia.

Correspondence: Christine Sammer, DrPH, RN, Director Corporate Patient Safety, Office of Clinical Effectiveness, Adventist Health System, 900 Hope Way, Altamonte Springs, FL 32714 (e-mail: christine.sammer@ahss.org).

The authors disclose no conflict of interest.

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