Definitions of AHRQ patient safety indicators
| Patient safety indicator | Numerator definition | Denominator definition | Key exclusions |
|---|---|---|---|
| All diagnosis based numerator definitions are based on secondary diagnoses unless otherwise noted. | |||
| DRG = diagnosis related group; MDC = major diagnostic category. | |||
| Anesthesia reactions and complications | Adverse effects of or poisoning by anesthetic, endotracheal tube wrongly placed | All surgical discharges | Poisoning due to drug dependence or abuse, self-inflicted injury |
| Death in low mortality DRGs | In-hospital death | DRGs with less than 0.5% mortality in 1997 NIS | Trauma, cancer, immune compromise |
| Decubitus ulcer | Pressure ulcer | All medical and surgical discharges with >4 day stay | MDC 9, admission from long term care, paralysis |
| Failure to rescue | In-hospital death | Acute renal failure, deep vein thrombosis, pulmonary embolus, pneumonia (including aspiration), shock, cardiac arrest, gastrointestinal hemorrhage/acute ulcer | Transfer to or from acute care hospital, admission from long term care, principal diagnosis related to the denominator condition |
| Foreign body left during procedure | Foreign body accidentally left during procedure | All medical and surgical discharges | None |
| Iatrogenic pneumothorax | Iatrogenic pneumothorax | All medical and surgical discharges | Trauma, cardiothoracic surgery, lung or pleural biopsy |
| Infection due to medical care | Infection following infusion, injection, or transfusion, or due to vascular device or graft | All medical and surgical discharges | Cancer, immune compromise |
| Postoperative hip fracture | Postoperative hip fracture | All surgical discharges | MDC 8, self-inflicted injury, cancers possibly metastatic to bone, children, principal diagnosis that could cause syncope or falls |
| Postoperative hemorrhage/hematoma | Postoperative hemorrhage/hematoma with surgical drainage or evacuation | All surgical discharges | Obstetric discharges |
| Postoperative physiological or metabolic derangement | Postoperative acute renal failure requiring dialysis or diabetic ketoacidosis, hyperosmolarity, or hypoglycaemic coma | All elective surgical discharges | Obstetric discharges, principal diagnosis causally related to the numerator condition |
| Postoperative respiratory failure | Postoperative acute or acute on chronic respiratory failure | All elective surgical discharges | MDC 4, MDC 5, obstetric discharges |
| Postoperative thromboembolism | Postoperative deep vein thrombosis or pulmonary embolus | All surgical discharges | Obstetric discharges, principal diagnosis of deep vein thrombosis |
| Postoperative septicemia | Postoperative septicemia | All elective surgical discharges with >3 day stay | Cancer, infection, immune compromise, obstetric discharges |
| Postoperative abdominopelvic wound dehiscence | Secondary procedure to close postoperative disruption of abdominal wall | All abdominopelvic surgical discharges | Obstetric discharges |
| Accidental puncture or laceration | Accidental puncture or laceration during procedure | All medical and surgical discharges | Obstetric discharges |
| Transfusion reaction | ABO or Rh transfusion reaction | All medical and surgical discharges | None |
| Birth trauma | Intracranial hemorrhage, extraclavicular fracture, spinal injury, nerve injury (other than facial and brachial plexus), other birth trauma | All live births | Preterm infants (for intracranial hemorrhage), osteogenesis imperfecta (for fracture) |
| Obstetric trauma (vaginal with instrumentation) | Principal or secondary diagnosis of fourth degree perineal, high vaginal, or cervical laceration; or procedure to repair any of these lacerations | All vaginal deliveries with forceps or vacuum | None |
| Obstetric trauma (vaginal without instrumentation) | Same | All vaginal deliveries without forceps or vacuum | None |
| Obstetric trauma (caesarean) | Same + uterine or urinary tract laceration; or procedure to repair any of these lacerations | All cesarean deliveries | None |