PDF(Pubmed)
Abstract：
Patient safety is a key quality issue for health systems. Healthcare acquired adverse events (AEs) compromise safety and quality; therefore, their reporting and monitoring is a patient safety priority. Although administrative datasets are potentially efficient tools for monitoring rates of AEs, concerns remain over the accuracy of their data. Chart review validation studies are required to explore the potential of administrative data to inform research and health policy. This review aims to present an overview of the methodological approaches and strategies used to validate rates of AEs in administrative data through chart review. This review was conducted in line with the Joanna Briggs Institute methodological framework for scoping reviews. Through database searches, 1054 sources were identified, imported into Covidence, and screened against the inclusion criteria. Articles that validated rates of AEs in administrative data through chart review were included. Data were extracted, exported to Microsoft Excel, arranged into a charting table, and presented in a tabular and descriptive format. Fifty-six studies were included. Most sources reported on surgical AEs; however, other medical specialties were also explored. Chart reviews were used in all studies; however, few agreed on terminology for the study design. Various methodological approaches and sampling strategies were used. Some studies used the Global Trigger Tool, a two-stage chart review method, whilst others used alternative single-, two-stage, or unclear approaches. The sources used samples of flagged charts (n = 24), flagged and random charts (n = 11), and random charts (n = 21). Most studies reported poor or moderate accuracy of AE rates. Some studies reported good accuracy of AE recording which highlights the potential of using administrative data for research purposes. This review highlights the potential for administrative data to provide information on AE rates and improve patient safety and healthcare quality. Nonetheless, further work is warranted to ensure that administrative data are accurate. The variation of methodological approaches taken, and sampling techniques used demonstrate a lack of consensus on best practice; therefore, further clarity and consensus are necessary to develop a more systematic approach to chart reviewing.
摘要：
背景技术患者安全是卫生系统的关键质量问题。医疗保健获得的不良事件(AE)损害了安全性和质量；因此，他们的报告和监测是患者安全的优先事项.尽管管理数据集是监测不良事件发生率的潜在有效工具，人们仍然担心他们的数据的准确性。需要进行图表审查验证研究，以探索行政数据为研究和卫生政策提供信息的潜力。本审查旨在通过图表审查来概述用于验证行政数据中不良事件发生率的方法方法和策略。方法本综述是根据JoannaBriggs研究所的范围审查方法框架进行的。通过数据库搜索，确定了1054个来源，导入Covidence，并根据纳入标准进行筛选。包括通过图表审查验证行政数据中不良事件发生率的文章。数据被提取，导出到MicrosoftExcel,安排在一张图表中，并以表格和描述性格式呈现。结果共纳入56个研究。然而，大多数来源报告了手术不良事件，还探索了其他医学专业。所有研究都使用图表综述，然而，很少有人同意研究设计的术语。使用了各种方法和抽样策略。一些研究使用了全局触发工具，两阶段图表审查方法，而其他人则使用替代的单一-，两阶段或不清楚的方法。来源使用标记图表的样本(n=24)，标记图和随机图(n=11)和随机图(n=21)。大多数研究报告不良事件发生率的准确性较差或中等。一些研究报告了不良事件记录的良好准确性，这突出了将管理数据用于研究目的的潜力。结论本综述强调了管理数据提供不良事件发生率信息并提高患者安全和医疗质量的潜力。尽管如此，需要进一步的工作来确保行政数据的准确性。所采取的方法论方法的变化，所使用的抽样技术表明对最佳实践缺乏共识，因此,需要进一步澄清和达成共识，以制定更系统的图表审查方法。
