Abstract
To examine the feasibility of detecting adverse events (AEs). A two-stage retrospective review of medical records. Seven hundred cases discharged during fiscal year 2002 were randomly selected from among inpatients, excluding psychiatric ward patients, hospitalized at seven acute-care hospitals. In the first stage of the review, trained nurse reviewers examined the medical records using 18 screening criteria to identify potential AEs. A nurse supervisor then reviewed all the cases judged as being criteria-negative by the first set of nurse reviewers and corrected the judgements as necessary. During the second stage of the review, a physician review team confirmed the occurrence, and categorized the AEs. Of the 700 cases, 79 (11.3%) cases were judged to have had AEs. Of the 79 cases, the AEs were the reason for the index admission in 26 cases, and the AEs occurred during the index admission in 53 cases. It was also judged that the AEs were highly preventable in 21 cases. Our judgement was consistent with that in the Australian survey. We confirmed the feasibility of the two-stage review process to detect AEs. To improve patient safety in Japanese hospitals, a nationwide survey, using this methodology, is necessary to fully understand the epidemiology of AEs, including the types of AEs and the contributory factors.
