Comparison between the WHO-CFICPS and the PRISMA Methods in the Classification of Safety-Related Events in a Single Radiation Oncology Department

Abstract

<h3>Purpose/Objective(s)</h3> To compare the WHO-CFICPS (World Health Organization's Conceptual Framework For The International Classification For Patient Safety) and the PRISMA (Prevention and Recovery Information System for Monitoring and Analysis) methods in the classification of Safety-Related Events (SREs) in a single radiation oncology department. <h3>Materials/Methods</h3> From February 2017 to October 2020, two Quality Managers (QM) classified 1173 reported SREs using the 13 incident types of the WHO-CFICPS. In March 2020, the same two QM, blinded to their previous WHO-CFICPS classification, began reclassifying the same SREs according to the 20 incident codes of the PRISMA method. Statistical analysis was performed to assess the association between the 13 incident types of the WHO-CFICPS and the 20 PRISMA codes. Chi-square test of independence and post-hoc tests using adjusted standardized residuals were applied to detect the association between the two classification systems. <h3>Results</h3> Overall, there was a significant association between the WHO-CFICPS incident types and the PRISMA method codes (p < 0.001). Ninety-two percent (1078 of 1173) of all SREs were categorized using only 4 of 13 WHO-CFICPS incident types: Clinical Process/Procedure (n=448, 38.2%), Clinical Administration (n=248, 21.1%), followed by Documentation (n=226, 19.2%) and Resources/Organizational Management (n=156,13.3%). whereas, in the PRISMA method, 14 of the 20 codes were used to describe the same SREs. In addition, the PRISMA method captured 41 Humans Skill Slips from 226 not better defined WHO-CFICPS Documentation Incidents and 40 Organization Management Priority events from 156 not better defined WHO-CFICPS Resources/Organizational Management events (p < 0.001). <h3>Conclusion</h3> Although there was a significant association between the WHO-CFICPS incident types and the PRISMA codes, the PRISMA method enables to better break down SREs compared to the WHO-CFICPS framework in a radiation oncology clinical setting.