Examining the Relationship of an All-Cause Harm Patient Safety Measure and Critical Performance Measures at the Frontline of Care

BACKGROUND: In 2015, the Institute of Medicine Vital Signs report called for a new patient safety composite measure to lessen the reporting burden of patient harm. Before this report, two patient safety organizations had developed an electronic all-cause harm measurement system leveraging data from the electronic health record, which identified and grouped harms into five broad categories and consolidated them into one all-cause harm outcome measure. OBJECTIVES: The objective of this study was to examine the relationship between this all-cause harm patient safety measure and the following three performance measures important to overall hospital safety performance: safety culture, employee engagement, and patient experience. METHODS: We studied the relationship between all-cause harm and three performance measures on eight inpatient care units at one hospital for 7 months. RESULTS: The findings demonstrated strong correlations between an all-cause harm measure and patient safety culture, employee engagement, and patient experience at the hospital unit level. Four safety culture domains showed significant negative correlations with all-cause harm at a P value of 0.05 or less. Six employee engagement domains were significantly negatively correlated with all-cause harm at a P value of 0.01 or less, and six of the ten patient experience measures were significantly correlated with all-cause harm at a P value of 0.05 or less. CONCLUSIONS: The results show that there is a strong relationship between all-cause harm and these performance measures indicating that when there is a positive patient safety culture, a more engaged employee, and a more satisfying patient experience, there may be less all-cause harm.