2.50
Hdl Handle:
http://hdl.handle.net/10755/157455
Type:
Presentation
Title:
THE INFLUENCE OF HOSPITAL SYSTEMS LOAD ON PATIENT SAFETY
Abstract:
THE INFLUENCE OF HOSPITAL SYSTEMS LOAD ON PATIENT SAFETY
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Blegen, Mary A., RN, PhD, FAAN
P.I. Institution Name:University of California San Francisco
Title:Professor
Contact Address:2 Koret #0608, San Francisco, CA, 94143, USA
Co-Authors:Alberta T. Pedroja; Bruce Spurlock; Rebecca Abravanel
PURPOSE: The purpose of this study was to determine whether there is a relationship between Hospital Systems Load and patient safety.
BACKGROUND: Hospital Systems Load was defined as the stress put on hospital systems as a function of the care needs of the patients in the hospital. Hospital Systems Load was defined as high demand for care and was expected to be associated with higher numbers of errors and patient harm.
METHODS: Data were obtained for each day of one year from two hospitals. These data included multiple potential system load indicators and de-identified incident reports. Each incident was weighted according to the level of patient harm before summing for a daily harm score and adjusting for number of patients at risk for incidents.
The investigators, consulting with administrative and clinical leaders from each hospital, identified potential indicators for Hospital System Load. Hospital IT personnel then provided the investigators with the data for each of the indicators for each day of a full year. These data were then factor analyzed to find groupings of indicators. One or two indicators were selected from each factor; then, each day of the year was categorized in quartiles for each indicator. Finally, a load score (count of system load indicators in the fourth/highest quartile) was assigned; e.g. 6 of 10 indicators in the highest quartile (Q4). Examples of system load indicators included midnight census, transfers in and out of units, surgical volumes, ED patients and diversions, OR minutes, overflow units volume, and PRN meds given.
RESULTS: Both hospitals had lower systems load and lower patient harm on weekends/ holidays compared to weekdays. Four sub-analyses calculated the correlation between Hospital System Load and Patient Harm - hospital A weekdays, weekend/holidays, hospital b weekdays, weekend/holidays. All four correlations were larger than 0.60 and statistically significant. In each analysis, as Hospital System Load increased, patient harm also increased.
IMPLICATIONS: Our data clearly demonstrated that it is safer in the hospital when the Hospital Systems Load is lighter. This offers wide implications for improvements in patient safety. If increases in Load are likely to add to the risk of patient harm, hospitals have only to determine at what levels they are at risk and implement a system intervention to protect patients from harm due to preventable adverse events. The results of this study also suggest that, contrary to popular opinion, patients in the hospital on weekends and holidays may be safer than on weekdays.
Project funded by the Betty Irene Moore Nursing Initiative of the Gordon and Betty Moore Foundation.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTHE INFLUENCE OF HOSPITAL SYSTEMS LOAD ON PATIENT SAFETYen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157455-
dc.description.abstract<table><tr><td colspan="2" class="item-title">THE INFLUENCE OF HOSPITAL SYSTEMS LOAD ON PATIENT SAFETY</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Blegen, Mary A., RN, PhD, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California San Francisco</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2 Koret #0608, San Francisco, CA, 94143, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Mary.Blegen@nursing.ucsf.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Alberta T. Pedroja; Bruce Spurlock; Rebecca Abravanel</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE: The purpose of this study was to determine whether there is a relationship between Hospital Systems Load and patient safety. <br/>BACKGROUND: Hospital Systems Load was defined as the stress put on hospital systems as a function of the care needs of the patients in the hospital. Hospital Systems Load was defined as high demand for care and was expected to be associated with higher numbers of errors and patient harm. <br/>METHODS: Data were obtained for each day of one year from two hospitals. These data included multiple potential system load indicators and de-identified incident reports. Each incident was weighted according to the level of patient harm before summing for a daily harm score and adjusting for number of patients at risk for incidents. <br/>The investigators, consulting with administrative and clinical leaders from each hospital, identified potential indicators for Hospital System Load. Hospital IT personnel then provided the investigators with the data for each of the indicators for each day of a full year. These data were then factor analyzed to find groupings of indicators. One or two indicators were selected from each factor; then, each day of the year was categorized in quartiles for each indicator. Finally, a load score (count of system load indicators in the fourth/highest quartile) was assigned; e.g. 6 of 10 indicators in the highest quartile (Q4). Examples of system load indicators included midnight census, transfers in and out of units, surgical volumes, ED patients and diversions, OR minutes, overflow units volume, and PRN meds given. <br/>RESULTS: Both hospitals had lower systems load and lower patient harm on weekends/ holidays compared to weekdays. Four sub-analyses calculated the correlation between Hospital System Load and Patient Harm - hospital A weekdays, weekend/holidays, hospital b weekdays, weekend/holidays. All four correlations were larger than 0.60 and statistically significant. In each analysis, as Hospital System Load increased, patient harm also increased. <br/>IMPLICATIONS: Our data clearly demonstrated that it is safer in the hospital when the Hospital Systems Load is lighter. This offers wide implications for improvements in patient safety. If increases in Load are likely to add to the risk of patient harm, hospitals have only to determine at what levels they are at risk and implement a system intervention to protect patients from harm due to preventable adverse events. The results of this study also suggest that, contrary to popular opinion, patients in the hospital on weekends and holidays may be safer than on weekdays. <br/>Project funded by the Betty Irene Moore Nursing Initiative of the Gordon and Betty Moore Foundation.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:53:18Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:53:18Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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