Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types

Kim Lyngby Mikkelsen, Jacob Thommesen, Henning Boje Andersen

    Research output: Contribution to journalJournal articleResearchpeer-review

    431 Downloads (Pure)

    Abstract

    Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO).
    Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types and subtypes of the Danish adaptation of the ICPS (ICPS-DK).
    Outcome Measures Two measures of inter-rater agreement: kappa and intra-class correlation (ICC).
    Results An average number of incident types used per case per rater was 2.5. The mean ICC was 0.521 (range: 0.199–0.809) and the mean kappa was 0.513 (range: 0.193–0.804). Kappa and ICC showed high correlation (r = 0.99). An inverse correlation was found between the prevalence of type and inter-rater reliability. Results are discussed according to four factors known to determine the inter-rater agreement: skill and motivation of raters; clarity of case descriptions; clarity of the operational definitions of the types and the instructions guiding the coding process; adequacy of the underlying classification scheme.
    Conclusions The incident types of the ICPS-DK are adequate, exhaustive and well suited for classifying and structuring incident reports. With a mean kappa a little above 0.5 the inter-rater agreement of the classification system is considered ‘fair’ to ‘good’. The wide variation in the inter-rater reliability and low reliability and poor discrimination among the highly prevalent incident types suggest that for these types, precisely defined incident sub-types may be preferred. This evaluation of the reliability and usability of WHO's ICPS should be useful for healthcare administrations that consider or are in the process of adapting the ICPS.
    Original languageEnglish
    JournalInternational Journal for Quality in Health Care
    Volume25
    Issue number2
    Pages (from-to)132-140
    ISSN1353-4505
    DOIs
    Publication statusPublished - 2013

    Bibliographical note

    © The Author 2013. Published by Oxford University Press.
    This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/3.0/),
    which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use,
    please contact journals.permissions@oup.com.

    Keywords

    • Adverse events
    • Patient safety
    • Incident reporting and analysis
    • Risk management
    • Taxonomy

    Cite this

    @article{0045e9e08dfc4636acbc17cd3f055bfd,
    title = "Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types",
    abstract = "Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO).Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types and subtypes of the Danish adaptation of the ICPS (ICPS-DK).Outcome Measures Two measures of inter-rater agreement: kappa and intra-class correlation (ICC).Results An average number of incident types used per case per rater was 2.5. The mean ICC was 0.521 (range: 0.199–0.809) and the mean kappa was 0.513 (range: 0.193–0.804). Kappa and ICC showed high correlation (r = 0.99). An inverse correlation was found between the prevalence of type and inter-rater reliability. Results are discussed according to four factors known to determine the inter-rater agreement: skill and motivation of raters; clarity of case descriptions; clarity of the operational definitions of the types and the instructions guiding the coding process; adequacy of the underlying classification scheme.Conclusions The incident types of the ICPS-DK are adequate, exhaustive and well suited for classifying and structuring incident reports. With a mean kappa a little above 0.5 the inter-rater agreement of the classification system is considered ‘fair’ to ‘good’. The wide variation in the inter-rater reliability and low reliability and poor discrimination among the highly prevalent incident types suggest that for these types, precisely defined incident sub-types may be preferred. This evaluation of the reliability and usability of WHO's ICPS should be useful for healthcare administrations that consider or are in the process of adapting the ICPS.",
    keywords = "Adverse events, Patient safety, Incident reporting and analysis, Risk management, Taxonomy",
    author = "Mikkelsen, {Kim Lyngby} and Jacob Thommesen and Andersen, {Henning Boje}",
    note = "{\circledC} The Author 2013. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com.",
    year = "2013",
    doi = "10.1093/intqhc/mzs080",
    language = "English",
    volume = "25",
    pages = "132--140",
    journal = "International Journal for Quality in Health Care",
    issn = "1353-4505",
    publisher = "Oxford University Press",
    number = "2",

    }

    Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types. / Mikkelsen, Kim Lyngby; Thommesen, Jacob; Andersen, Henning Boje.

    In: International Journal for Quality in Health Care, Vol. 25, No. 2, 2013, p. 132-140.

    Research output: Contribution to journalJournal articleResearchpeer-review

    TY - JOUR

    T1 - Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types

    AU - Mikkelsen, Kim Lyngby

    AU - Thommesen, Jacob

    AU - Andersen, Henning Boje

    N1 - © The Author 2013. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com.

    PY - 2013

    Y1 - 2013

    N2 - Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO).Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types and subtypes of the Danish adaptation of the ICPS (ICPS-DK).Outcome Measures Two measures of inter-rater agreement: kappa and intra-class correlation (ICC).Results An average number of incident types used per case per rater was 2.5. The mean ICC was 0.521 (range: 0.199–0.809) and the mean kappa was 0.513 (range: 0.193–0.804). Kappa and ICC showed high correlation (r = 0.99). An inverse correlation was found between the prevalence of type and inter-rater reliability. Results are discussed according to four factors known to determine the inter-rater agreement: skill and motivation of raters; clarity of case descriptions; clarity of the operational definitions of the types and the instructions guiding the coding process; adequacy of the underlying classification scheme.Conclusions The incident types of the ICPS-DK are adequate, exhaustive and well suited for classifying and structuring incident reports. With a mean kappa a little above 0.5 the inter-rater agreement of the classification system is considered ‘fair’ to ‘good’. The wide variation in the inter-rater reliability and low reliability and poor discrimination among the highly prevalent incident types suggest that for these types, precisely defined incident sub-types may be preferred. This evaluation of the reliability and usability of WHO's ICPS should be useful for healthcare administrations that consider or are in the process of adapting the ICPS.

    AB - Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO).Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types and subtypes of the Danish adaptation of the ICPS (ICPS-DK).Outcome Measures Two measures of inter-rater agreement: kappa and intra-class correlation (ICC).Results An average number of incident types used per case per rater was 2.5. The mean ICC was 0.521 (range: 0.199–0.809) and the mean kappa was 0.513 (range: 0.193–0.804). Kappa and ICC showed high correlation (r = 0.99). An inverse correlation was found between the prevalence of type and inter-rater reliability. Results are discussed according to four factors known to determine the inter-rater agreement: skill and motivation of raters; clarity of case descriptions; clarity of the operational definitions of the types and the instructions guiding the coding process; adequacy of the underlying classification scheme.Conclusions The incident types of the ICPS-DK are adequate, exhaustive and well suited for classifying and structuring incident reports. With a mean kappa a little above 0.5 the inter-rater agreement of the classification system is considered ‘fair’ to ‘good’. The wide variation in the inter-rater reliability and low reliability and poor discrimination among the highly prevalent incident types suggest that for these types, precisely defined incident sub-types may be preferred. This evaluation of the reliability and usability of WHO's ICPS should be useful for healthcare administrations that consider or are in the process of adapting the ICPS.

    KW - Adverse events

    KW - Patient safety

    KW - Incident reporting and analysis

    KW - Risk management

    KW - Taxonomy

    U2 - 10.1093/intqhc/mzs080

    DO - 10.1093/intqhc/mzs080

    M3 - Journal article

    C2 - 23287641

    VL - 25

    SP - 132

    EP - 140

    JO - International Journal for Quality in Health Care

    JF - International Journal for Quality in Health Care

    SN - 1353-4505

    IS - 2

    ER -