Chartbook on Patient Safety

Patient Safety Measures That Improved Quickly or Showed Worsening Quality

• One Patient Safety measure improved quickly, defined as an average annual rate of change greater than 10% per year:
  • Central line-associated bloodstream infection per 1,000 medical and surgical discharges, age 18+ or obstetric admissions.
• One Patient Safety measure showed worsening quality:
  • Postoperative physiologic and metabolic derangements per 1,000 elective-surgery discharges, age 18+.

Disparities in Patient Safety Measures

Number and percentage of patient safety measures for which members of selected groups experienced better, same, or worse quality of care compared with reference group

Key: n = number of measures.

Note: Poor indicates family income less than the Federal poverty level; High Income indicates family income four times the Federal poverty level or greater. Numbers of measures differ across groups because of sample size limitations. For most measures, data from 2012 are shown. The relative difference between a selected group and its reference group is used to assess disparities.

• Better = Population received better quality of care than reference group. Differences are statistically significant, are equal to or larger than 10%, and favor the selected group.
• Same = Population and reference group received about the same quality of care. Differences are not statistically significant or are smaller than 10%.
• Worse = Population received worse quality of care than reference group. Differences are statistically significant, are equal to or larger than 10%, and favor the reference group.

• For about one-third of patient safety measures:
  • People in poor households received worse care than people in high-income households.
  • Blacks and Asians received worse care than Whites.

Patient Safety Measures With Elimination or Widening of Disparities

• Four Patient Safety measures showed elimination of Black-White disparities:
  • Mechanical adverse events in patients receiving central venous catheter placement, age 18+.
  • Hospital patients with an anticoagulant-related adverse drug event to low-molecular- weight heparin and factor Xa, age 18+.
  • Postoperative respiratory failure per 1,000 elective-surgery discharges, age 18+.
  • Admissions with iatrogenic pneumothorax per 1,000 discharges, age 18+.
• One Patient Safety measure showed widening of an Asian-White disparity:
  • Admissions with iatrogenic pneumothorax per 1,000 discharges, age 18+.

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Measures of Patient Safety

• In addition to summarizing information on patient safety from the National Healthcare Quality and Disparities Report, this chartbook tracks individual measures of patient safety, overall and for populations defined by age, race, ethnicity, income, education, insurance, and number of chronic conditions.
• Measures of Patient Safety are organized by setting and include:
  • Hospitals.
  • Nursing homes.
  • Home health.
  • Ambulatory care.
  • All settings: Infrastructure.

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