Medical record review of deaths, unexpected intensive care unit admissions, and clinician referrals: Detection of adverse events and insight into the system

K L Dunn; Prasuna Reddy; A Moulden; G Bowes

doi:10.1136/adc.2005.074179

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Medical record review of deaths, unexpected intensive care unit admissions, and clinician referrals: Detection of adverse events and insight into the system

Journal article

Peer reviewed

Medical record review of deaths, unexpected intensive care unit admissions, and clinician referrals: Detection of adverse events and insight into the system

K L Dunn, Prasuna Reddy, A Moulden and G Bowes

Archives of Disease in Childhood, Vol.91(2), pp.169-172

2006

DOI: https://doi.org/10.1136/adc.2005.074179

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Abstract

Aims and Methods: To determine whether a programme of continuous medical record review of deaths, unexpected intensive care unit (ICU) admissions, and admissions referred by medical and nursing staff for specific review, would provide a range of adverse events from which to gain insight into the healthcare system of a large paediatric referral hospital. A quality assurance programme was commenced in 1996. Results: Over a six year period there were 103 255 admissions; 1612 (1.6%) records were reviewed, from which 325 adverse events were detected. Events were associated with operations, procedures and anaesthesia (56.5%), diagnosis and therapy (24%), drug and fluid management (12.6%), and system issues (7%). Medical records were reviewed from 23 of the 28 clinical units. Review of the records and analysis of the adverse events triggered many system changes. Conclusions: The findings suggest that continuous medical record review may be a valuable method for the detection of adverse events and identifying system issues in children's hospitals.

Details

Title: Medical record review of deaths, unexpected intensive care unit admissions, and clinician referrals: Detection of adverse events and insight into the system
Authors: K L Dunn (Author) - University of Melbourne
Prasuna Reddy (Author) - University of Melbourne
A Moulden (Author) - Royal Children's Hospital
G Bowes (Author) - University of Melbourne
Publication details: Archives of Disease in Childhood, Vol.91(2), pp.169-172
Publisher: B M J Group
Date published: 2006
DOI: 10.1136/adc.2005.074179
ISSN: 0003-9888
Organisation Unit: University of the Sunshine Coast, Queensland
Language: English
Record Identifier: 99450679002621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Pediatrics

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