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Limited external reproducibility restricts the use of medical record review for benchmarking

BACKGROUND: Medical record review (MRR) is used to assess the quality and safety in hospitals. It is increasingly used to compare institutions. Therefore, the external reproducibility should be high. In the current study, we evaluated this external reproducibility for the assessment of an adverse ev...

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Autores principales: Klein, Dorthe O, Rennenberg, Roger, Gans, Rijk, Enting, Roelien, Koopmans, Richard, Prins, Martin H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542435/
https://www.ncbi.nlm.nih.gov/pubmed/31206063
http://dx.doi.org/10.1136/bmjoq-2018-000564
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author Klein, Dorthe O
Rennenberg, Roger
Gans, Rijk
Enting, Roelien
Koopmans, Richard
Prins, Martin H
author_facet Klein, Dorthe O
Rennenberg, Roger
Gans, Rijk
Enting, Roelien
Koopmans, Richard
Prins, Martin H
author_sort Klein, Dorthe O
collection PubMed
description BACKGROUND: Medical record review (MRR) is used to assess the quality and safety in hospitals. It is increasingly used to compare institutions. Therefore, the external reproducibility should be high. In the current study, we evaluated this external reproducibility for the assessment of an adverse event (AE) in a sample of records from two university medical centres in the Netherlands, using the same review method. METHODS: From both hospitals, 40 medical records were randomly chosen from patient files of deceased patients that had been evaluated in the preceding years by the internal review committees. After reviewing by the external committees, we assessed the overall and kappa agreement by comparing the results of both review rounds (once by the own internal committee and once by the external committee). This was calculated for the presence of an AE, preventability and contribution to death. RESULTS: Kappa for the presence of AEs was moderate (k=0.47). For preventability, the agreement was fair (k=0.39) and poor for contribution to death (k=−0.109). CONCLUSION: We still believe that MRR is suitable for the detection of general issues concerning patient safety. However, based on the outcomes of this study, we would advise to be careful when using MRR for benchmarking.
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spelling pubmed-65424352019-06-14 Limited external reproducibility restricts the use of medical record review for benchmarking Klein, Dorthe O Rennenberg, Roger Gans, Rijk Enting, Roelien Koopmans, Richard Prins, Martin H BMJ Open Qual Original Article BACKGROUND: Medical record review (MRR) is used to assess the quality and safety in hospitals. It is increasingly used to compare institutions. Therefore, the external reproducibility should be high. In the current study, we evaluated this external reproducibility for the assessment of an adverse event (AE) in a sample of records from two university medical centres in the Netherlands, using the same review method. METHODS: From both hospitals, 40 medical records were randomly chosen from patient files of deceased patients that had been evaluated in the preceding years by the internal review committees. After reviewing by the external committees, we assessed the overall and kappa agreement by comparing the results of both review rounds (once by the own internal committee and once by the external committee). This was calculated for the presence of an AE, preventability and contribution to death. RESULTS: Kappa for the presence of AEs was moderate (k=0.47). For preventability, the agreement was fair (k=0.39) and poor for contribution to death (k=−0.109). CONCLUSION: We still believe that MRR is suitable for the detection of general issues concerning patient safety. However, based on the outcomes of this study, we would advise to be careful when using MRR for benchmarking. BMJ Publishing Group 2019-04-25 /pmc/articles/PMC6542435/ /pubmed/31206063 http://dx.doi.org/10.1136/bmjoq-2018-000564 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Original Article
Klein, Dorthe O
Rennenberg, Roger
Gans, Rijk
Enting, Roelien
Koopmans, Richard
Prins, Martin H
Limited external reproducibility restricts the use of medical record review for benchmarking
title Limited external reproducibility restricts the use of medical record review for benchmarking
title_full Limited external reproducibility restricts the use of medical record review for benchmarking
title_fullStr Limited external reproducibility restricts the use of medical record review for benchmarking
title_full_unstemmed Limited external reproducibility restricts the use of medical record review for benchmarking
title_short Limited external reproducibility restricts the use of medical record review for benchmarking
title_sort limited external reproducibility restricts the use of medical record review for benchmarking
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542435/
https://www.ncbi.nlm.nih.gov/pubmed/31206063
http://dx.doi.org/10.1136/bmjoq-2018-000564
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