Towards an International Classification for Patient Safety: key concepts and terms

Abstract

Background: Understanding the patient safety literature has been compromised by the inconsistent use of language.

Objective: To identify key concepts of relevance to the International Patient Safety Classification (ICPS) proposed by the World Alliance For Patient Safety of the World Health Organization (WHO), and agree on definitions and preferred terms.

Methods: Six principles were agreed upon-that the concepts and terms should: be applicable across the full spectrum of healthcare; be consistent with concepts from other WHO Classifications; have meanings as close as possible to those in colloquial use; convey the appropriate meanings with respect to patient safety; be brief and clear, without unnecessary or redundant qualifiers; be fit-for-purpose for the ICPS.

Results: Definitions and preferred terms were agreed for 48 concepts of relevance to the ICPS; these were described and the relationships between them and the ICPS were outlined.

Conclusions: The consistent use of key concepts, definitions and preferred terms should pave the way for better understanding, for comparisons between facilities and jurisdictions, and for trends to be tracked over time. Changes and improvements, translation into other languages and alignment with other sets of patient safety definitions will be necessary. This work represents the start of an ongoing process of progressively improving a common international understanding of terms and concepts relevant to patient safety.

Figure 1

Conceptual framework for the ICPS. Solid lines enclose the 10 major classes of the ICPS and represent the semantic relationships between them. The dotted lines link relevant preferred terms to classes. The numbers in parentheses as given in Table 2 represent the sequence in which they appear in the text and in Table 1.