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Towards an International Classification for Patient Safety: the conceptual framework
Open accessAbstract
Global advances in patient safety have been hampered by the lack of a uniform classification of patient safety concepts. This is a significant barrier to developing strategies to reduce risk, performing evidence-based research and evaluating existing healthcare policies relevant to patient safety. Since 2005, the World Health Organization's World Alliance for Patient Safety has undertaken the Project to Develop an International Classification for Patient Safety (ICPS) to devise a classification which transforms patient safety information collected from disparate systems into a common format to facilitate aggregation, analysis and learning across disciplines, borders and time. A drafting group, comprised of experts from the fields of patient safety, classification theory, health informatics, consumer/patient advocacy, law and medicine, identified and defined key patient safety concepts and developed an internationally agreed conceptual framework for the ICPS based upon existing patient safety classifications. The conceptual framework was iteratively improved through technical expert meetings and a two-stage web-based modified Delphi survey of over 250 international experts. This work culminated in a conceptual framework consisting of ten high level classes: incident type, patient outcomes, patient characteristics, incident characteristics, contributing factors/hazards, organizational outcomes, detection, mitigating factors, ameliorating actions and actions taken to reduce risk. While the framework for the ICPS is in place, several challenges remain. Concepts need to be defined, guidance for using the classification needs to be provided, and further real-world testing needs to occur to progressively refine the ICPS to ensure it is fit for purpose.
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“The framework is based upon existing classifications such as AIMS, with additional input from international experts in safety, systems engineering, health policy, medicine, and the law.5 28 29”
From An analysis of computer-related patient safety incidents to inform the development of a classification (2010) · cites this paper as [28]
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Towards an International Classification for Patient Safety: key concepts and terms
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Self-citationTowards an International Classification for Patient Safety: a Delphi survey
Thomson, R., Lewalle, P., Sherman, H., Hibbert, P., Runciman, W., & Castro, G. (2009) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzn055 · Cited by 87
Self-citationPerneger, T. (2006) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzl008 · Cited by 5
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Background
Metadata
- Authors
- The World Alliance For Patient Safety Drafting Group, Sherman, H., Castro, G., Fletcher, M., on behalf of The World Alliance for Patient Safety, Hatlie, M., Hibbert, P., Jakob, R., Koss, R., Lewalle, P., Loeb, J., Perneger, T., Runciman, W., Thomson, R., Van Der Schaaf, T., & Virtanen, M.
- Affiliations
- Joint Commission (US)
- National Patient Safety Agency (GB)
- World Health Organization (CH)
- Royal Adelaide Hospital (AU)
- University Hospital of Geneva (CH)
- Newcastle University (GB)
- Corresponding author
- Sherman, H.
- Venue
- International Journal for Quality in Health Care
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-02-01
- Volume
- 21
- Issue
- 1
- Pages
- 2-8
- ISSN
- 1353-4505 (ISSN-L)
- 1464-3677
- PMC
- PMC2638753
- OpenAlex
- W2138968928
- Cited by
- 281
- References
- 6
- Citations by year
- 2026: 17 · 2025: 14 · 2024: 22 · 2023: 14 · 2022: 26 · 2021: 19 · 2020: 13 · 2019: 12 · 2018: 14 · 2017: 13 · 2016: 23 · 2015: 17 · 2014: 22 · 2013: 17 · 2012: 7
- FWCI
- 17.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal for Quality in Health Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- TU/e Research Portal (publishedVersion, other-oa)
- reroDoc Digital Library (submittedVersion)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion, cc-by-nc)
- TU/e Research Portal (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc)
- Document Server@UHasselt (UHasselt) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- TU/e Research Portal (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
- Keywords
- patient safety, conceptual framework, incident classification, patient outcomes, contributing factors, risk mitigation, World Alliance for Patient Safety, Delphi method, health informatics
- MeSH terms
- Concept Formation, International Cooperation, Safety Management, Medical Errors
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