The Stepwise Assessment Indicator Framework Approach
The 'Stepwise Assessment Indicator Framework Approach' shown is not an individual report of the Workpackage 4 of the SIMPATIE project. Text and tables shown are a subpart of the chapter 'Description of the Work' of the WP4 report 'Establishing a Set of Patient Safety Indicators', march 2007 (for a direct link to this chapter, see here).
The developed Stepwise Assessment Indicator Framework Approach to select, characterise, and evaluate appropriate indicators is illustrated below. If the indicator does not fulfil all the required demands of a step, it is deleted and not taken any further. The steps are described below.
Step 1. Selecting the Indicator
Making sure the indicator addresses relevant and significant patient safety issues: it qualifies as an indicator according to the definition in Table 1, and it can be placed within the bold frame in Table 2.
Table 1. Definition of a Patient Safety Indicator
If the indicator does not fulfil the required demands of step 1, it is deleted.
Step 2. Characterising the Indicator
To characterise the indicators Scheme for Characterisation of Indicators is used. It is vital for this step that both the numerator and the denominator are defined.
Step 3. Evaluating the Indicator - a brief rating instrument for external application
Indicators were evaluated by each individual member of the expert group using the scoring sheet integrated in the Brief Assessment Instrument.
If the indicator does not fulfil the required demands of step 3 it is deleted. Only indicators meeting all demands in the “Stepwise Assessment Framework Approach” have been fully characterised, evaluated, and recommended.
Step 4. Recommendations for use of the indicator in Europe
Registering and analysing the PSIs has to be feasible. It is crucial, therefore, to aim for a limited set of PSIs that when possible can draw upon existing registries or databases within hospitals and be used for benchmarking. It would be an illusion to think that all aspect of patient safety could be adequately captured in such a set of PSIs.
As the expert group was not able to make definite statements about exact data availability and quality for all the PSIs in all European countries it strived to take cross-cultural registration practices into account in making recommendations for PSI application. The PSIs are divided into four sets dependent on whether the expert group found them:
1. Immediately workable throughout the European health care systems
2. Immediately workable in parts of the European health care systems
3. At present not workable for implementation in Europe – Recommendation for future decision on implementation or
4. Not suitable as a PSI for recommendation in Europe
