title: A pilot study on record reviewing with a priori patient selection.
abstract: OBJECTIVE
  To investigate whether a priori selection of patient records using unexpectedly long length of stay (UL-LOS) leads to detection of more records with adverse events (AEs) compared to non-UL-LOS.
  
  
  METHODS
  To investigate the opportunities of the UL-LOS, we looked for AEs in all records of patients with colorectal cancer. Within this group, we compared the number of AEs found in records of patients with a UL-LOS with the number found in records of patients who did not have a UL-LOS.
  
  
  METHODS
  Our study was done at a general hospital in The Netherlands. The hospital is medium sized with approximately 30 000 admissions on an annual basis. The hospital has two major locations in different cities where both primary and secondary care is provided.
  
  
  METHODS
  The patient records of 191 patients with colorectal cancer were reviewed.
  
  
  METHODS
  Number of triggers and adverse events were the primary outcome measures.
  
  
  RESULTS
  In the records of patients with colorectal cancer who had a UL-LOS, 51% of the records contained one or more AEs compared with 9% in the reference group of non-UL-LOS patients. By reviewing only the UL-LOS group with at least one trigger, we found in 84% (43 out of 51) of these records at least one adverse event.
  
  
  CONCLUSIONS
  A priori selection of patient records using the UL-LOS indicator appears to be a powerful selection method which could be an effective way for healthcare professionals to identify opportunities to improve patient safety in their day-to-day work.
authors.affiliation: Dutch Hospital Data, Utrecht, The Netherlands.
authors.forename: Sezgin
authors.initials: S
authors.lastname: Cihangir
authors.forename: Ine
authors.initials: I
authors.lastname: Borghans
authors.forename: Karin
authors.initials: K
authors.lastname: Hekkert
authors.forename: Hein
authors.initials: H
authors.lastname: Muller
authors.forename: Gert
authors.initials: G
authors.lastname: Westert
authors.forename: Rudolf B
authors.initials: RB
authors.lastname: Kool
keywords: Colorectal cancer; Length of Stay; Public Health; Record reviewing; trigger tool