Safety Data for safer care: The importance of international consensus and action

Abstract

Objective Interest in comparative quality measurement and evaluation has grown considerably over the past two decades due to several factors, such as recognition of widespread variation in clinical practice, the increased availability of evidence on medical effectiveness, and increasing concern about the cost and quality of healthcare. Interest in ensuring that healthcare is safe has grown, particularly since 2001 when the Institute of Medicine (IOM) included patient safety as another quality dimension. This interest in safety is not limited by international borders or by classifications of “more developed” or “less developed” countries. International initiatives at the highest levels of government such as the Organization for Economic Cooperation and Development's (OECD) Health Care Quality Indicators Project and its Patient Safety Working Group, as well as the World Alliance for Patient Safety, highlight the need for international agreement to increase learning on patient safety. However, little is being done to improve the availability and comparability of data/indicators on patient safety within and between countries. Material and method In this paper, we describe the work being done by national bodies such as the US Agency for Healthcare Research and Quality (AHRQ), and international organizations such as the OECD and the World Alliance (WHO) to improve safety data with a view to providing safer care. At the same time, we compare this with information existing in Spain on this same question. Results The proposal by the OECD attempts to identify suitable measurements to enable comparisons at international level, although several difficulties (availability of data, ethical aspects, organization of the systems) mean that the number of indicators has been reduced. The indicators proposed by the AHRQ, based on several solid information sources, offer a much clearer vision as regards patient safety at national level. In Spain, there are initiatives for international comparisons using the indicators proposed by the OECD and, at national level, using the proposals by AHRQ, based on the MBDS (minimum basic data set). Conclusions The development of patient safety data systems, both at national and international level, still has a long way to go. One important aspect to consider, is the need to involve patients and their associations in the collection and recording of data on patient safety.