BACKGROUND: Limited data are available on adverse events among children admitted to hospital. The Canadian Paediatric Adverse Events Study was done to describe the epidemiology of adverse events among children in hospital in Canada. METHODS: We performed a 2-stage medical record review at 8 academic pediatric centres and 14 community hospitals in Canada. We reviewed charts from patients admitted from April 2008 through March 2009, evenly distributed across 4 age groups (0 to 28 d; 29 to 365 d; > 1 to 5 yr and > 5 to 18 yr). In stage 1, nurses and health records personnel who had received training in the use of the Canadian Paediatric Trigger Tool reviewed medical records to detect triggers for possible adverse events. In stage 2, physicians reviewed the charts identified as having triggers and described the adverse events. RESULTS: A total of 3669 children were admitted to hospital during the study period. The weighted rate of adverse events was 9.2%. Adverse events were more frequent in academic pediatric centres than in community hospitals (adjusted odds ratio [OR] 2.98, 95% confidence interval [CI] 1.65-5.39). The incidence of preventable adverse events was not significantly different between types of hospital, but nonpreventable adverse events were more common in academic pediatric centres (adjusted OR 4.39, 95% CI 2.08-9.27). Surgical events predominated overall and occurred more frequently in academic pediatric centres than in community hospitals (37.2% v. 21.5%, relative risk [RR] 1.7, 95% CI 1.0-3.1), whereas events associated with diagnostic errors were significantly less frequent (11.1% v. 23.1%, RR 0.5, 95% CI 0.2-0.9). INTERPRETATION: More children have adverse events in academic pediatric centres than in community hospitals; however, adverse events in the former are less likely to be preventable. There are many opportunities to reduce harm affecting children in hospital in Canada, particularly related to surgery, intensive care and diagnostic error.
BACKGROUND: Limited data are available on adverse events among children admitted to hospital. The Canadian Paediatric Adverse Events Study was done to describe the epidemiology of adverse events among children in hospital in Canada. METHODS: We performed a 2-stage medical record review at 8 academic pediatric centres and 14 community hospitals in Canada. We reviewed charts from patients admitted from April 2008 through March 2009, evenly distributed across 4 age groups (0 to 28 d; 29 to 365 d; > 1 to 5 yr and > 5 to 18 yr). In stage 1, nurses and health records personnel who had received training in the use of the Canadian Paediatric Trigger Tool reviewed medical records to detect triggers for possible adverse events. In stage 2, physicians reviewed the charts identified as having triggers and described the adverse events. RESULTS: A total of 3669 children were admitted to hospital during the study period. The weighted rate of adverse events was 9.2%. Adverse events were more frequent in academic pediatric centres than in community hospitals (adjusted odds ratio [OR] 2.98, 95% confidence interval [CI] 1.65-5.39). The incidence of preventable adverse events was not significantly different between types of hospital, but nonpreventable adverse events were more common in academic pediatric centres (adjusted OR 4.39, 95% CI 2.08-9.27). Surgical events predominated overall and occurred more frequently in academic pediatric centres than in community hospitals (37.2% v. 21.5%, relative risk [RR] 1.7, 95% CI 1.0-3.1), whereas events associated with diagnostic errors were significantly less frequent (11.1% v. 23.1%, RR 0.5, 95% CI 0.2-0.9). INTERPRETATION: More children have adverse events in academic pediatric centres than in community hospitals; however, adverse events in the former are less likely to be preventable. There are many opportunities to reduce harm affecting children in hospital in Canada, particularly related to surgery, intensive care and diagnostic error.
Authors: E J Thomas; D M Studdert; H R Burstin; E J Orav; T Zeena; E J Williams; K M Howard; P C Weiler; T A Brennan Journal: Med Care Date: 2000-03 Impact factor: 2.983
Authors: G Ross Baker; Peter G Norton; Virginia Flintoft; Régis Blais; Adalsteinn Brown; Jafna Cox; Ed Etchells; William A Ghali; Philip Hébert; Sumit R Majumdar; Maeve O'Beirne; Luz Palacios-Derflingher; Robert J Reid; Sam Sheps; Robyn Tamblyn Journal: CMAJ Date: 2004-05-25 Impact factor: 8.262
Authors: Alisa Khan; Maitreya Coffey; Katherine P Litterer; Jennifer D Baird; Stephannie L Furtak; Briana M Garcia; Michele A Ashland; Sharon Calaman; Nicholas C Kuzma; Jennifer K O'Toole; Aarti Patel; Glenn Rosenbluth; Lauren A Destino; Jennifer L Everhart; Brian P Good; Jennifer H Hepps; Anuj K Dalal; Stuart R Lipsitz; Catherine S Yoon; Katherine R Zigmont; Rajendu Srivastava; Amy J Starmer; Theodore C Sectish; Nancy D Spector; Daniel C West; Christopher P Landrigan; Brenda K Allair; Claire Alminde; Wilma Alvarado-Little; Marisa Atsatt; Megan E Aylor; James F Bale; Dorene Balmer; Kevin T Barton; Carolyn Beck; Zia Bismilla; Rebecca L Blankenburg; Debra Chandler; Amanda Choudhary; Eileen Christensen; Sally Coghlan-McDonald; F Sessions Cole; Elizabeth Corless; Sharon Cray; Roxi Da Silva; Devesh Dahale; Benard Dreyer; Amanda S Growdon; LeAnn Gubler; Amy Guiot; Roben Harris; Helen Haskell; Irene Kocolas; Elizabeth Kruvand; Michele Marie Lane; Kathleen Langrish; Christy J W Ledford; Kheyandra Lewis; Joseph O Lopreiato; Christopher G Maloney; Amanda Mangan; Peggy Markle; Fernando Mendoza; Dale Ann Micalizzi; Vineeta Mittal; Maria Obermeyer; Katherine A O'Donnell; Mary Ottolini; Shilpa J Patel; Rita Pickler; Jayne Elizabeth Rogers; Lee M Sanders; Kimberly Sauder; Samir S Shah; Meesha Sharma; Arabella Simpkin; Anupama Subramony; E Douglas Thompson; Laura Trueman; Tanner Trujillo; Michael P Turmelle; Cindy Warnick; Chelsea Welch; Andrew J White; Matthew F Wien; Ariel S Winn; Stephanie Wintch; Michael Wolf; H Shonna Yin; Clifton E Yu Journal: JAMA Pediatr Date: 2017-04-01 Impact factor: 16.193
Authors: Debbie S Gipson; Eric S Kirkendall; Brenda Gumbs-Petty; Theresa Quinn; A Steen; Amanda Hicks; Ann McMahon; Savian Nicholas; Anna Zhao-Wong; Perdita Taylor-Zapata; Mark Turner; Emily Herreshoff; Charlotte Jones; Jonathan M Davis; Margaret Haber; Steven Hirschfeld Journal: Pediatrics Date: 2017-01 Impact factor: 7.124
Authors: David C Stockwell; Christopher P Landrigan; Sara L Toomey; Samuel S Loren; Jisun Jang; Jessica A Quinn; Sepideh Ashrafzadeh; Michelle J Wang; Melody Wu; Paul J Sharek; David C Classen; Rajendu Srivastava; Gareth Parry; Mark A Schuster Journal: Pediatrics Date: 2018-07-13 Impact factor: 7.124
Authors: Gileh-Gol Akhtar-Danesh; Aristithes G Doumouras; Cecily Bos; Helene Flageole; Dennis Hong Journal: JAMA Surg Date: 2018-06-01 Impact factor: 14.766