Measuring Patient Harm in Canadian Hospitals: Technical Report

Table of Contents

• Table of contents 3
• Definitions and scope 5
• Background 5
• Definition 5
• Hospital Harm Framework 6
• Scope of the measure 7
• Clinical group selection 7
• Category A: Health Care–/Medication-Associated Conditions 7
• Category B: Health Care–Associated Infections 8
• Category C: Patient Accidents 8
• Category D: Procedure-Associated Conditions 8
• General methodology 8
• Data source 8
• Denominator: Hospital discharges 9
• Inclusion criteria 9
• Exclusion criteria 9
• Numerator: Discharges with at least 1 occurrence of harm 9
• Counting harm 9
• Complexity score 10
• Additional resource estimates 11
• Costing 11
• Bed days 12
• Clinical groups: Definition, concept and methodology 13
• Category A: Health Care–/Medication-Associated Conditions 13
• A01: Anemia — Hemorrhage 13
• A02: Obstetric Hemorrhage 14
• A03: Obstetric Trauma 16
• A04: Birth Trauma 18
• A05: Delirium 20
• A06: Venous Thromboembolism 21
• A07: Altered Blood Glucose Level With Complications 22
• A08: Pressure Ulcer 23
• A09: Electrolyte and Fluid Imbalance 23
• A10: Medication Incidents 24
• A11: Infusion, Transfusion and Injection Complications 25
• Category B: Health Care–Associated Infections 26
• B12: Urinary Tract Infections 26
• B13: Post-Procedural Infections 27
• B14: Gastroenteritis 28
• B15: Pneumonia 29
• B16: Aspiration Pneumonia 31
• B17: Sepsis 32
• B18: Infections Due to Clostridium difficile, MRSA or VRE 35
• Category C: Patient Accidents 37
• C19: Patient Trauma 38
• Category D: Procedure-Associated Conditions 39
• D01: Anemia — Hemorrhage 39
• D02: Obstetric Hemorrhage 39
• D03: Obstetric Trauma 41
• D04: Birth Trauma 43
• D19: Patient Trauma 45
• D20: Device Failure 46
• D21: Laceration/Puncture 48
• D22: Pneumothorax 48
• D23: Wound Disruption 49
• D24: Retained Foreign Body 49
• D25: Post-Procedural Shock 50
• D26: Selected Serious Events 50
• Appendix 1: Definition of diagnosis type and diagnosis cluster 52
• Appendix 2: Code descriptions 53
• Appendix 3: List of ICD-10-CA infection codes 56
• Appendix 4: Text alternative for Hospital Harm Framework 67
• References 68