News: Study shows link between clinically validated PSIs and patient outcomes

Call it a no-brainer but recent research shows a “strong association” related to “clinically validated” patient safety indicators (PSIs) and patient outcomes such as increased length of stay and high rates of hospital readmissions and mortality. It is a no-brainer because PSIs are a set of measures that screen for adverse events that patients experience as a result of exposure to the healthcare system, events and conditions which, theoretically could be prevented by changes in care or processes.

The key phrase here is “clinically validated” as the new study, published in the American Journal of Medical Quality, cites various other recent reports which question PSI methodology including “significant coding and documentation errors as well as inadequate criteria for PSI classification.”

To clinically validate its sample, the Ohio researchers took more 2,089 PSI cases flagged between 2012 and 2014 and re-examined the records to ensure the appropriateness of that PSI designation whittling the list down to 1,847. When researchers analyzed this group of records, they identified different clinical results from predecessors’ findings. For example, previous studies agree that the two PSIs most significantly associated with excess mortality before discharge are postoperative respiratory failure and postoperative sepsis, but the present study found the highest mortality among patients with postoperative respiratory failure or postoperative physiologic and metabolic derangement.

“The present study findings underscore the importance of clinical validation of PSIs. The authors believe that avoidance of false positives, which can be the result of coding errors, coding misinterpretation, and insufficient documentation, may benefit hospitals that are at risk for disincentive by CMS.”