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Selecting Indicators for Patient Safety at the Health System Level in OECD Countries

The Issue

There are no robust and reliable data with which to assess the safety of health systems across nations. This Commonwealth Fund–supported study describes work undertaken as part of the Organization for Economic Cooperation and Development (OECD) Health Care Quality Indicators Project to develop an initial set of international patient safety indicators.

What the Study Found

Members of an expert panel selected 59 patient safety indicators from OECD countries and rated them against the following criteria: importance, scientific soundness, and potential feasibility. The resulting list of 21 indicators falls into five categories: hospital-acquired infections, operative and postoperative complications, sentinel events, obstetrics, and other care-related events.


According to the authors, this indicator set is a good first step, although it has significant limitations. First, the indicators are all related to adverse events: left out are "near misses" and adherence to safe care processes. Further, the indicators focus on hospital care rather than primary care, nursing home care, or care in other settings. Finally, the indicators' usefulness may be limited by lack of available data, underreporting, and the fact that some types of adverse events are very rare, making it difficult to use the data for comparative analyses.

Publication Details



V. McLoughlin, J. Millar, S. Mattke et al., "Selecting Indicators for Patient Safety at the Health System Level in OECD Countries," International Journal for Quality in Health Care, Sept. 2006 18(Suppl. 1):14–20.