Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical populatio

L. M. McElroy, D. M. Woods, A. F. Yanes, A. I. Skaro, A. Daud, T. Curtis, E. Wymore, J. L. Holl, M. M. Abecassis, D. P. Ladner

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Objective: Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test the applicability of the ICPS to a surgical population. Design: Aweb-based safety debriefing was sent to clinicians involved in surgical care of abdominal organ transplant patients. A multidisciplinary team of patient safety experts, surgeons and researchers used the data to develop a system of classification based on the ICPS. Disagreements were reconciled via consensus, and a codebook was developed for future use by researchers. Results: A total of 320 debriefing responses were used for the initial review and codebook development. In total, the 320 debriefing responses contained 227 patient safety incidents (range: 0-7 per debriefing) and 156 contributing factors/hazards (0-5 per response). The most common severity classification was 'reportable circumstance,' followed by 'near miss.' The most common incident types were 'resources/organizational management,' followed by 'medical device/equipment.' Several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions and handoffs. Conclusions: This study demonstrates that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data. Several unique aspects of surgical care require consideration, and by using a standardized framework for describing concepts, research findings can be compared and disseminated across surgical specialties. The codebook is intended for use as a framework for other specialties and institutions.

Original languageEnglish (US)
Article numbermzw001
Pages (from-to)166-174
Number of pages9
JournalInternational Journal for Quality in Health Care
Issue number2
StatePublished - Apr 1 2016
Externally publishedYes


  • Medical errors/classification
  • Patient safety
  • Risk assessment
  • Surgery
  • Transplantation
  • World health organization

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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