Patient safety indicators for acute care hospitals: a systematic review

A systematic review was conducted to identify the strategies used in the development of patient safety indicators for acute care hospitals. The data sources were MEDLINE, EMBASE, websites, and reference lists from articles and documents. Fourteen projects on the development of indicators were included. The review showed the use of different terms with varying definitions of quality and patient safety. The literature review and participation by specialists and other stakeholders characterized the projects. Of the 285 identified indicators, 125 were classified in more than one quality dimension. The most frequent combination was safety and effectiveness. Most were medication indicators, and more than half were outcome indicators. In developing patient safety indicators, the results show the importance of considering variations in culture and medical practice, the availability of information systems, and the capacity of hospitals and health systems to implement effective monitoring systems.