Validating the Patient Safety Indicators in the Veterans Health Administration

Abstract

Overall, PPVs were moderate for most of the PSIs. Implementing POA codes and using more specific ICD-9-CM codes would improve their validity. Our results suggest that additional coding improvements are needed before the PSIs evaluated herein are used for hospital reporting or pay for performance.

Comparing VA and Non-VA Quality of Care: A Systematic Review

“…[47][48][49] Effectiveness Seventeen studies showed better performance in VA facilities, while three had similar performance, one was mixed, and three were worse than non-VA settings. 51 Receipt of diabetes education and annual HbA1c tests was higher among VA patients compared with veterans in non-VA care.…”

Using AHRQ Patient Safety Indicators to Detect Postdischarge Adverse Events in the Veterans Health Administration

“…Some of the post-discharge PSI events we detected may be false positives (previous work examining the validity of selected PSIs found that after accounting for POA, the positive predictive values ranged from 46-90%). 12 Thus, we may have overestimated the yield of true events that can be detected by applying modified PSI criteria to post-discharge data. We suggest that future studies use chart review to validate the post-discharge PSIs.…”

“…Since the PSIs are a reasonably valid and cost-efficient means of identifying AEs, 12 policymakers may consider using the PSI algorithms to measure post-discharge morbidity associated with hospital quality. Unlike 30-day readmissions, the PSIs identify specific complications associated with hospital care.…”

“…[9][10][11] Our study expands upon this previous work by evaluating post-discharge AE detection among a wider set of ten PSIs that was recently validated in the Veterans Health Administration (VA). 12 Additionally, we explore the number of AEs detected in outpatient encounters, an area of patient safety research that has received little attention. The objective of this paper is to examine the feasibility of applying PSI criteria to detect AEs in the 30-day post-discharge period using both VA inpatient and outpatient administrative data.…”

Behavioral medicine translation in the Veterans Health Administration: editorial to the special section on the Department of Veterans Affairs

“…The VHA has moved beyond the first generation of its electronic health record and its extensive national administrative datasets and is now developing second and third generation informatics products for VHA clinicians, patients, managers, and scientists. Administrative data are available for rapid identification of unintended consequences of health care policy [16] and adverse events [19], threats to patient safety [20], and access to care barriers [11,15]. Clinical datasets with the administrative data support large-scale epidemiological research and observational studies of interventions.…”