Patient-safety indicators: a systematic review, criteria-based characterization and prioritization

Objective To identify and classify internationally published and applied patient safety indicators (PSIs) and their caracterization as a subgroup of quality indicators. Prioritizing PSIs considering the need for action on patient safety of the German health care and their validation by applying scientific quality criteria. Methods A systematic review of publications indexed from January 2000 to December 2009 was conducted using Medline and websites of institutions. PSIs were characterized as a subgroup of quality indicators by defined criteria and prioritized using a criteria-based procedure. Results A total of 2,973 PSIs were identified and classified in a PSI-database. A Medline search resulted in 1,568 PSIs and 1,405 PSIs were identified by analyzing indicator sets of institutions. Finally, 60 PSIs were the result of prioritizing and validating the search outcomes. Discussion The characterization of PSIs and the criteria-based instrument were suitable to identify appropriate PSIs, so that they can be validated later on using a Delphi-method and a pilot and can be eventually implemented into practice.