Table 2 Definitions

Adverse event

(1) An unintended injury or complication, which results in (2) disability at discharge, death or prolongation of hospital stay, and (3) is caused by healthcare management (including omissions) rather than the patient’s disease [4].

Unintended injury

Refers to any disadvantage for the patient that leads to prolonged or strengthened treatment, temporary or permanent (physical or mental) impairment or death [11].

Disability

Refers to temporary or permanent impairment of physical or mental function attributable to the adverse event (including prolonged or strengthened treatment, prolonged hospital stay, readmission, subsequent hospitalization, extra outpatient department consultations or death) [11].

Causation

Refers to injury caused by health care management including acts of omission (inactions) i.e. failure to diagnose or treat, and acts of commission (affirmative actions) i.e. incorrect diagnosis or treatment, or poor performance [11].

Health Care Management

Includes the actions of individual hospital staff as well as the broader systems and care processes and includes both acts of omission (failure to diagnose or treat) and acts of commission (incorrect diagnosis or treatment, or poor performance) [10].

Preventable Adverse Event

An injury that is caused by medical intervention or management (rather than the disease process) and either prolonged hospital stay or caused disability at discharge, where there was enough information currently available to have avoided the event using currently accepted practices [16].

Higher Level of Care

A higher level of care may include:

1.

An unplanned transfer to an Intensive Care Unit,

2.

An intervention of a Medical Emergency Team or

3.

A redo procedure within 24 hours of ICU patients.

Intensive Care Units (ICUs)

Hospital units providing continuous surveillance and care to actually ill patients (Mesh definition).

E.g. medical and surgical ICUs, for example Medium Care, Coronary Care Units, Pediatric ICUs and Respiratory Care Units.

Planned ICU admissions

Admissions of patients expected to arrive on the ICU.

E.g. routinely scheduled post-surgery admissions or transfers directly to the ICU from outside hospitals.

Unplanned ICU admissions

All patients unexpectedly admitted to the intensive care unit from a lower level of care in the hospital during the study period. If a patient experienced more than one unplanned ICU admission during his/her hospital stay, each unplanned admission is included in the analysis (adapted from Baker, 2009) [17].

Patient harm

Unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment or hospitalization, or that results in death (IHI) [18].