Quality of care analyses using ICD11 : Detailed capture of treatment events

Abstract

The identification of treatment errors, the so-called "undesirable" or "critical incidents", is crucial for improving and developing the quality of care. The new International Statistical Classification of Diseases and Related Health Problems-ICD-11-supports astructured data collection in the context of the quality of care and patient safety. Documentation conceptually relies on the multiple coding of the three dimensions of acritical incident: harm, cause, and mode. In this way, it is possible to capture the event in great detail, including the reasons for it and the effects it has. Anevaluation of this concept in afield trial using 45 clinical case studies showed good concordance in coding across the documented participants.As the ICD-11 permits the detailed capture of near misses and their context, it could be used for structured documentation in incident reporting systems (databanks for the anonymous reporting of treatment errors). In this way, the error reports can be gathered in a more systematic way, so that they can be used for better quality improvement.In quality assessment, it is important to consider the time of diagnosis. Thus, the feature present on admission (POA) is a diagnosis qualifier that is of substantial importance for quality assessment and is widely used internationally. Up to now, it has not been permanently available in Germany. ICD-11 includes therelevant code.