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dc.contributor.authorWalsh, Kathleen E.
dc.contributor.authorHarik, Polina
dc.contributor.authorMazor, Kathleen M.
dc.contributor.authorPerfetto, Deborah
dc.contributor.authorAnatchkova, Milena D.
dc.contributor.authorBiggins, Colleen
dc.contributor.authorWagner, Joann
dc.contributor.authorSchoettker, Pamela J.
dc.contributor.authorFirneno, Cassandra
dc.contributor.authorKlugman, Robert
dc.contributor.authorTjia, Jennifer
dc.date2022-08-11T08:08:22.000
dc.date.accessioned2022-08-23T15:52:22Z
dc.date.available2022-08-23T15:52:22Z
dc.date.issued2017-04-01
dc.date.submitted2017-06-30
dc.identifier.citation<p>Med Care. 2017 Apr;55(4):436-441. doi: 10.1097/MLR.0000000000000679. <a href="https://doi.org/10.1097/MLR.0000000000000679">Link to article on publisher's site</a></p>
dc.identifier.issn0025-7079 (Linking)
dc.identifier.doi10.1097/MLR.0000000000000679
dc.identifier.pmid27906769
dc.identifier.urihttp://hdl.handle.net/20.500.14038/29120
dc.description.abstractOBJECTIVE: The objective of this study was to identify modifiable factors that improve the reliability of ratings of severity of health care-associated harm in clinical practice improvement and research. METHODS: A diverse group of clinicians rated 8 types of adverse events: blood product, device or medical/surgical supply, fall, health care-associated infection, medication, perinatal, pressure ulcer, surgery. We used a generalizability theory framework to estimate the impact of number of raters, rater experience, and rater provider type on reliability. RESULTS: Pharmacists were slightly more precise and consistent in their ratings than either physicians or nurses. For example, to achieve high reliability of 0.83, 3 physicians could be replaced by 2 pharmacists without loss in precision of measurement. If only 1 rater was available for rating, approximately 5% of the reviews for severe harm would have been incorrectly categorized. Reliability was greatly improved with 2 reviewers. CONCLUSIONS: We identified factors that influence the reliability of clinician reviews of health care-associated harm. Our novel use of generalizability analyses improved our understanding of how differences affect reliability. This approach was useful in optimizing resource utilization when selecting raters to assess harm and may have similar applications in other settings in health care.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=27906769&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1097/MLR.0000000000000679
dc.subjectpatient safety
dc.subjectgeneralizability theory
dc.subjecthealthcare associated harm
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.titleMeasuring Harm in Health Care: Optimizing Adverse Event Review
dc.typeJournal Article
dc.source.journaltitleMedical care
dc.source.volume55
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/1346
dc.identifier.contextkey10382239
html.description.abstract<p>OBJECTIVE: The objective of this study was to identify modifiable factors that improve the reliability of ratings of severity of health care-associated harm in clinical practice improvement and research.</p> <p>METHODS: A diverse group of clinicians rated 8 types of adverse events: blood product, device or medical/surgical supply, fall, health care-associated infection, medication, perinatal, pressure ulcer, surgery. We used a generalizability theory framework to estimate the impact of number of raters, rater experience, and rater provider type on reliability.</p> <p>RESULTS: Pharmacists were slightly more precise and consistent in their ratings than either physicians or nurses. For example, to achieve high reliability of 0.83, 3 physicians could be replaced by 2 pharmacists without loss in precision of measurement. If only 1 rater was available for rating, approximately 5% of the reviews for severe harm would have been incorrectly categorized. Reliability was greatly improved with 2 reviewers.</p> <p>CONCLUSIONS: We identified factors that influence the reliability of clinician reviews of health care-associated harm. Our novel use of generalizability analyses improved our understanding of how differences affect reliability. This approach was useful in optimizing resource utilization when selecting raters to assess harm and may have similar applications in other settings in health care.</p>
dc.identifier.submissionpathfaculty_pubs/1346
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages436-441


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