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Am J Med Qual. 2009 Nov-Dec;24(6):465-73. doi: 10.1177/1062860609341585. Epub 2009 Aug 20.

"Canary measures" among the AHRQ patient safety indicators.

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  • 1RAND Corporation, Pittsburgh, Pennsylvania 15213, USA.


Despite the fact that the Agency for Healthcare Research and Quality patient safety indicators (PSIs) are useful for evaluating adverse events in hospitals, the 20 PSIs make it difficult to summarize broad trends across indicators. This study aims to identify 1 or more measures among the PSIs best suited for a quick index of general patient safety status. The 1997-2002 Nationwide Inpatient Sample was used to calculate the hospital-level risk-adjusted rates of the PSIs. Both pairwise correlation analyses and multivariate analyses showed that PSI #7 (Selected infections due to medical care) is significantly correlated with most of the other PSIs. The results are robust even when (1) the pairwise and multivariate analyses are rerun on a reduced data set that excludes admissions with multiple patient safety events, and (2) Bonferroni-adjusted P values are calculated. The study concludes that PSI #7 appears to be a candidate for a quick index of patient safety status.

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