Retrospective medical record evaluation: reliability in assessing causation, preventability, and disability of adverse events.

in International Journal of Health Care Quality Assurance (2012), 25(8), 649-62

PURPOSE: The purpose of this article is to assess the reliability of an in-depth analysis on causation, preventability, and disability by two separate review teams on five selected adverse events in acute ... [more ▼]

PURPOSE: The purpose of this article is to assess the reliability of an in-depth analysis on causation, preventability, and disability by two separate review teams on five selected adverse events in acute hospitals: pressure ulcer, postoperative pulmonary embolism or deep vein thrombosis, postoperative sepsis, ventilator-associated pneumonia and postoperative wound infection. DESIGN/METHODOLOGY/APPROACH: The analysis uses a retrospective medical record review of 1,515 patient records by two independent teams in eight acute Belgian hospitals for the year 2005. The Mann-Whitney U-test is used to identify significant differences between the two review teams regarding occurrence of adverse events as well as regarding the degree of causation, preventability, and disability of found adverse events. FINDINGS: Team 1 stated a high probability for health care management causation in 95.5 per cent of adverse events in contrast to 38.9 per cent by Team 2. Likewise, high preventability was considered in 83.1 per cent of cases by Team 1 versus 51.7 per cent by Team 2. Significant differences in degree of disability between the two teams were also found for pressure ulcers, postoperative pulmonary embolism or deep vein thrombosis and postoperative wound infection, but not for postoperative sepsis and ventilator-associated pneumonia. ORIGINALITY/VALUE: New insight on the degree of and reasons for the huge differences in adverse event evaluation is provided. [less ▲]

Patient out-of-pocket contributions related to hip fracture hospital costs in Belgium

in Osteoporosis International (2011, March), 22(Suppl.1), 333

Assessing the causes inducing lengthening of hospital stays by means of the Appropriateness Evaluation Protocol.

in Health Policy (2011)

OBJECTIVES: The objective is to evaluate the use of the Appropriateness Evaluation Protocol (AEP) as a screening tool for determining the causes of the non-justified days to help hospitals to decrease the ... [more ▼]

OBJECTIVES: The objective is to evaluate the use of the Appropriateness Evaluation Protocol (AEP) as a screening tool for determining the causes of the non-justified days to help hospitals to decrease the length of stay while preserving the quality of care. METHODS: Three successive cross-sectional surveys were conducted from 2003 till 2005, in 23 Belgian hospitals. During this period, 10921 days were audited by means of the AEP. This study is focused on adult acute non-intensive care units. The appropriateness of each day of the sample was assessed, and for those considered as inappropriate, the reasons explaining the prolongation of the stay were investigated. RESULTS: The proportion of inappropriate days was 24.61%. There is a high variability across specialties and hospitals. Regarding inappropriate days, the analysis of causes of prolongation, globally, by bed index or by hospital, indicated clearly internal and external factors that lengthen stays. The most frequent reasons are waits for an examination (22%) and the lack of extra-hospital structures (31%). CONCLUSIONS: The use of AEP as a tool of internal audit to measure the proportion of non-justified days and their causes turns out to be possible and the obtained results has provided some accurate and useful information for the participating, and allowed them to take concrete decisions which lead to shrinking of the length of hospital stay. [less ▲]

Etude de la qualité de vie après la mise en place d’une prothèse de hanche ou de genou pour cause d’arthrose : une étude de cohorte avec un suivi de 7 ans

in Revue du Rhumatisme (2010, November), 77(Suppl.3), 141

Health-related quality of life after total knee or hip replacement: a 7-year prospective study

in Annals of the Rheumatic Diseases (2010, June), 69(Suppl.3), 469

Board certified physicians in health informatics

in Swiss Medical Informatics [=SMI] (2010), 70

Board certified physicians in health informatics. A european precedent for professional regognition

in International medical informatics association (2010)

Geographical Variations in the Use of Three Elective Surgical Procedures in the Elderly

Poster (2009)

Detection of Adverse Events in Administrative Data

Report (2008)

Revision of the Belgian Nursing Minimum Dataset: From concept to implementation

in Studies in Health Technology & Informatics (2006), 122

The Ministry of Public Health commissioned a research project to the Catholic University of Leuven and the University Hospital of Liege to revise the Belgian Nursing Minimum Dataset (B-NMDS). The study ... [more ▼]

The Ministry of Public Health commissioned a research project to the Catholic University of Leuven and the University Hospital of Liege to revise the Belgian Nursing Minimum Dataset (B-NMDS). The study started in 2000 and will end with the implementation of the revised B-NMDS in January 2007. The study entailed four major phases. The first phase involved the development of a conceptual framework based on a literature review and secondary data analysis. The second phase focused on language development and development of a data collection tool. The third phase focused on data collection and validation of the new tool. In the fourth phase the validity and reliability of the dataset was tested. The new dataset is without avail if it is not leading to new information. Four applications of the dataset has been defined from the beginning: evaluation of the appropriateness of stay (AEP) in the hospital, nurse staffing, hospital financing and quality management. The aim of this paper is to describe how the B-NMDS can contribute to each of these applications. [less ▲]