title: Design of a medical record review study on the incidence and preventability of adverse events requiring a higher level of care in Belgian hospitals.
abstract: BACKGROUND
  Adverse events are unintended patient injuries that arise from healthcare management resulting in disability, prolonged hospital stay or death. Adverse events that require intensive care admission imply a considerable financial burden to the healthcare system. The epidemiology of adverse events in Belgian hospitals has never been assessed systematically.
  
  
  RESULTS
  A multistage retrospective review study of patients requiring a transfer to a higher level of care will be conducted in six hospitals in the province of Limburg. Patient records are reviewed starting from January 2012 by a clinical team consisting of a research nurse, a physician and a clinical pharmacist. Besides the incidence and the level of causation and preventability, also the type of adverse events and their consequences (patient harm, mortality and length of stay) will be assessed. Moreover, the adequacy of the patient records and quality/usefulness of the method of medical record review will be evaluated.
  
  
  CONCLUSIONS
  This paper describes the rationale for a retrospective review study of adverse events that necessitate a higher level of care. More specifically, we are particularly interested in increasing our understanding in the preventability and root causes of these events in order to implement improvement strategies. Attention is paid to the strengths and limitations of the study design.
authors.affiliation: Hasselt University, Faculty of Medicine, Patient Safety Group, Agoralaan Building D, Room D58, Diepenbeek 3590, Belgium. annemie.vlayen@uhasselt.be
authors.forename: Annemie
authors.initials: A
authors.lastname: Vlayen
authors.forename: Kristel
authors.initials: K
authors.lastname: Marquet
authors.forename: Ward
authors.initials: W
authors.lastname: Schrooten
authors.forename: Arthur
authors.initials: A
authors.lastname: Vleugels
authors.forename: Johan
authors.initials: J
authors.lastname: Hellings
authors.forename: Elke
authors.initials: E
authors.lastname: De Troy
authors.forename: Frank
authors.initials: F
authors.lastname: Weekers
authors.forename: Neree
authors.initials: N
authors.lastname: Claes
mesh_terms: D001530:Belgium / Q000453:epidemiology; D016000:Cluster Analysis; D004185:Disability Evaluation; D006761:Hospitals; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology / Q000517:prevention & control*; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008485:Medical Audit; D019300:Medical Errors / Q000401:mortality / Q000517:prevention & control*; D008499:Medical Records; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission; D061214:Patient Safety; D010360:Patient Transfer; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors