Building Patient Safety EnvironmentThe Hospital Patient Safety Indicator
Building Patient Safety Environment─The Hospital Patient Safety Indicator System n Patient safety has recently become a very important issue in the World Health Organization and also in both developed and developing countries. The Department of Health (DOH) of Taiwan is also dedicated to improving healthcare quality and thus, established its Patient Safety Committee in 2003. Taiwan Joint Commission on Hospital Accreditation (TJCHA) also lists patient safety as its first priority in hospital accreditation. In the same year, Taiwan Hospital Association and DOH invited professionals from various fields and representatives from hospitals to put together patient safety clinical practice guidelines. The importance of patient safety cannot be overemphasized judging from all these efforts. In this study, we try to establish a patient safety indicator series, which can help Taiwan’s hospitals monitor patient safety, meanwhile, reduce medical errors and ensure a safer healthcare environment. We first sort out the related patient safety indicators in this country and internationally. The next step was to form an expert panel that selected 339 items form our initial listing. Finally, we designed a questionnaire consisting of 67 indicators. We then applied the modified Delphi Technique to build up consensus among experts in terms of validity and reliability so as to come up with the most suitable indicators for Taiwan. The results demonstrated the experts feel that 90% of the indicators in the questionnaire applicable. Nineteen indicators were deleted after the modified Delphi round. In the end, we selected 48 items in the final set of patient safety indicators. Of them, 20 indicators were adopted from the Taiwan Healthcare Indicator Series (THIS), 10 indicators from American Hospital Association, 7 indicators from Agency for Healthcare Quality and Research, and 11 indicators were modified from THIS and the Taiwan Quality Indicator Project (TQIP). Our indicators focus not only on prescription, blood transfusion and medication, but also on infection control and medical malpractice. The results indicated that the expert panel in this study paid great attention to medication safety and medical safety, which coincide with the patient safety objectives of DOH and the Joint Commission on Accreditation of Healthcare Organization of USA.
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