title: Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.
abstract: OBJECTIVE
  Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test the applicability of the ICPS to a surgical population.
  
  
  METHODS
  A web-based safety debriefing was sent to clinicians involved in surgical care of abdominal organ transplant patients. A multidisciplinary team of patient safety experts, surgeons and researchers used the data to develop a system of classification based on the ICPS. Disagreements were reconciled via consensus, and a codebook was developed for future use by researchers.
  
  
  RESULTS
  A total of 320 debriefing responses were used for the initial review and codebook development. In total, the 320 debriefing responses contained 227 patient safety incidents (range: 0-7 per debriefing) and 156 contributing factors/hazards (0-5 per response). The most common severity classification was 'reportable circumstance,' followed by 'near miss.' The most common incident types were 'resources/organizational management,' followed by 'medical device/equipment.' Several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions and handoffs.
  
  
  CONCLUSIONS
  This study demonstrates that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data. Several unique aspects of surgical care require consideration, and by using a standardized framework for describing concepts, research findings can be compared and disseminated across surgical specialties. The codebook is intended for use as a framework for other specialties and institutions.
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: McElroy
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Woods
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: Yanes
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: A I
authors.initials: AI
authors.lastname: Skaro
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: A
authors.initials: A
authors.lastname: Daud
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: T
authors.initials: T
authors.lastname: Curtis
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: E
authors.initials: E
authors.lastname: Wymore
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Holl
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Abecassis
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Ladner
mesh_terms: D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000592:standards; D016031:Liver Transplantation / Q000009:adverse effects / Q000592:standards; D019300:Medical Errors / Q000145:classification* / Q000517:prevention & control; D008962:Models, Theoretical; D061214:Patient Safety / Q000592:standards; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000592:standards*; D014944:World Health Organization
keywords: medical errors/classification; patient safety; risk assessment; surgery; transplantation; world health organization