Detection of adverse events in a Scottish hospital using a consensus-based methodology

D. J. Williams, S. Olsen, W. Crichton, K. Witte, R. Flin, J. Ingram, M. K. Campbell, M. Watson, Y. Hopf, B. H. Cuthbertson

Research output: Contribution to journalArticlepeer-review

28 Citations (SciVal)


Objective: To determine, using a consensus based methodology, the rate and nature of adverse events (AEs) among patients admitted to acute medicine, acute surgery and obstetrics in a large teaching hospital in Scotland. Methods: Retrospective case-note review of 450 medical, nursing and medication records to identify and classify adverse events. Results: For 354 patients whose length of stay was greater than 24 hours, the overall adverse event rate was 7.9% which ranged from 0% in obstetrics, 7.2% in acute medicine to 13% in acute surgery. Among all AEs, 43% were deemed preventable by a consensus group and 59% of the AEs contributed to a proportion of the patients' hospital stay or led to hospital readmission. Whilst nurse identification of adverse events was highly specific (94%), its sensitivity was poor (43%). Only 10% of the identified AEs were identified by the hospital's voluntary reporting system for adverse events. The estimated additional cost of adverse events in terms of bed days was £69,189 which if extrapolated Scotland-wide could cost £297 million per annum. Conclusions: This study supports the need to continue the traditional retrospective record review to identify adverse events. The current hospital-based reporting of adverse events does not provide a complete measure of adverse events and needs to be complemented by other measures.

Original languageEnglish
Pages (from-to)26-30
Number of pages5
JournalScottish Medical Journal
Issue number4
Publication statusPublished - Dec 2008

ASJC Scopus subject areas

  • Medicine(all)


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