tion is detecting most adverse events that occur. The term “audit” can describe a series of activities ranging from unstructured self-assessments (National Quality Forum) to comprehensive reviews of structure, process, and outcomes (Joint Commission on Accreditation of Healthcare Organizations). For patient safety data standards, audit means independent review of injury case finding, evaluation, and classification using explicit criteria for the structure and function of the data systems and for the review process itself. The aim of a data system audit should be to provide assurance that the numbers reported are reasonably complete, accurate, and reproducible and thus useful for shared analysis and comparison. By design, such an audit does not address how a health care organization responds to the injury data obtained or produce judgments about safety performance. In other industries, such audit assurance is an essential element of transparency and a potent antidote to misrepresentation, cheating, and corruption. Research is needed to develop fully functional quality-of-care audit criteria and to determine how such systems might be administered.


Agency for Healthcare Research and Quality. 2001. Ways You Can Help Your Family Prevent Medical Errors. Online. Available: http://www.ahcpr.gov/consumer/5tipseng/5tips.pdf [accessed July 30, 2003].

Bates, D. W., R. S. Evans, H. Murff, P. D. Stetson, L. Pizziferri, and G. Hripcsak. 2003. Detecting adverse events using information technology. J Am Med Inform Assoc 10 (2):115–128.

Classen, D. C., S. L. Pestotnik, R. S. Evans, and J. P. Burke. 1991. Computerized surveillance of adverse drug events in hospital patients. JAMA 266 (20):2847–2851.

Classen, D. C., R. S. Evans, S. L. Pestotnik, S. D. Horn, R. L. Menlove, and J. P. Burke. 1992. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 326 (5):337–339.

Evans, R. S., R. A. Larsen, J. P. Burke, R. M. Gardner, F. A. Meier, J. A. Jacobson, M. T. Conti, J. T. Jacobson, and R. K. Hulse. 1986. Computer surveillance of hospital-acquired infections and antibiotic use. JAMA 256 (8):1007–1011.

Evans, R. S., S. L. Pestotnik, D. C. Classen, S. D. Horne, S. B. Bass, and J. P. Burke. 1994. Preventing adverse drug events in hospitalized patients. Ann Pharmacother 28 (4):523–527.

Gawande, A. A., E. J. Thomas, M. J. Zinner, and T. A. Brennan. 1999. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 126 (1):66–75.

Henz, S. 2000. Improved ADR Detection Without Using a Computer-Assisted Alert System. Salt Lake City, UT: Institute of Healthcare Delivery Research.

James, B. C. 1989. Quality Management for Health Care Delivery. Chicago, IL: Hospital Research and Education Trust (American Hospital Association).

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