The association between patient-reported incidents in hospitals and estimated rates of patient harm

Int J Qual Health Care. 2015 Feb;27(1):26-30. doi: 10.1093/intqhc/mzu087. Epub 2014 Nov 21.


Objective: The aim of this study was to test the association between the rates of patient-reported incidents and patient harm documented in the patient record.

Design: The study was a secondary analysis of two national hospital assessments conducted in 2011.

Setting: Hospital services in Norway.

Participants: The patient survey was a standard national patient-experience survey conducted at the hospital level for all 63 hospitals in Norway. The medical record review was performed by 47 Global Trigger Tools (GTTs) in all 19 hospital trusts and 4 private hospitals. The two data sets were matched at the unit level, yielding comparable patient experiences and GTT data for 7 departments, 16 hospitals and 11 hospital trusts.

Intervention: No intervention.

Main outcome measures: The correlation at the unit level between the patient-reported incident in hospital instrument (PRIH-I) and estimated rates of patient harm from the GTT.

Results: The PRIH-I index was significantly correlated with all patient-reported experience indicators at the individual level, with estimates for all patient harm events (Categories E-I) at the unit level (r = 0.62, P < 0.01), and with estimates of more serious harm events in Categories F-I (r = 0.42, P < 0.05).

Conclusions: Patient-reported incidents in hospitals, as measured by the PRIH-I, are strongly correlated with patient harm rates based on the GTT. This indicates that patient-reported incidents are related to patient safety, but more research is needed to confirm the usefulness of patient reporting in the evaluation of patient safety.

Keywords: GTT; hospital; patient experiences; patient safety; questionnaire.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Data Collection / methods*
  • Humans
  • Medical Errors / statistics & numerical data*
  • Medical Records / statistics & numerical data*
  • Norway
  • Patient Harm / statistics & numerical data*
  • Patient Safety
  • Risk Management / statistics & numerical data*
  • Safety Management