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Detecting and reducing hospital adverse events: Outcomes of the Wimmera clinical risk management program

journal contribution
posted on 2001-06-18, 00:00 authored by A M Wolff, J Bourke, I A Campbell, D W Leembruggen
Objectives: To determine if an integrated clinical risk management program that detects adverse patient events in a hospital, analyses their risk and takes action can alter the rate of adverse events. Design: Longitudinal survey of adverse patient events over eight years of progressive implementation of the risk management program. Participants and setting: 49 834 inpatients (July 1991 to September 1999) and 20 050 emergency department patients (October 1997 to September 1999) at a rural base hospital in the Wimmera region of Victoria. Main outcome measures: Rates of adverse events detected by medical record review and clinical incident and general practitioner reporting. Results: The annual rate of inpatient adverse events decreased between the first and eight years of the study from 1.35% of all patient discharges (69 events) to 0.74% (49 events) (P < 0.001). Absolute risk reduction was 0.61% (95% CI, 0.23%-0.99%), and relative risk reduction was 44.9% (95% CI, 16.9%-72.9%). The quarterly rate of emergency department adverse events decreased between the first and eighth quarters of monitoring from 3.26% of all attendances (84 events) to 0.48% (12 events) (P < 0.001). Absolute risk reduction was 2.78% (95% CI, 2.04%-3.52%), and relative risk reduction was 85.3% (95% CI, 62.7%-100%). Conclusions: Adverse patient events can be detected, and their frequency reduced, using multiple detection methods and clinical improvement strategies as part of an integrated clinical risk management program.

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Journal

Medical Journal of Australia

Volume

174

Issue

12

Pagination

621 - 625

ISSN

0025-729X

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