The JCAHO patient safety event taxonomy: a standardized terminology and classification schema for near misses and adverse events

Abstract

The results suggest that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Patient Safety Event Taxonomy could facilitate a common approach for patient safety information systems. Having access to standardized data would make it easier to file patient safety event reports and to conduct root cause analyses in a consistent fashion.

Spinal Adverse Events Severity System, version 2 (SAVES-V2): inter- and intraobserver reliability assessment

“…3,5,9,11,15 Current terminology, such as "complication," "AE," "adverse occurrence," or "near misses," can have different meanings but are often used interchangeably. Furthermore, most AE studies use undefined terms, such as "major" or "minor" events, and obJective Reporting of adverse events (AEs) in spinal surgery uses inconsistent definitions and severity grading, making it difficult to compare results between studies.…”

“…1,15,24,27,28,42 Despite significant efforts by international organizations and policy makers, a common language for medical error is still not globally used. 2,5,9,15,17,29 A comprehensive patient safety event taxonomy was developed and published in 2005 by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). 5,14,40 Although the report was appropriately reflective regarding the scope and depth of patient safety assessment, the complexity of this system requires a potentially prohibitive amount of resources and commitment from all levels of health care in order to be universally implemented.…”

Assessment of knowledge and attitudes towards safety events reporting among residents in a community health system

“…The goals of event reporting portals are to facilitate problem identification and mitigation of risk in order to minimize and prevent patient harm by gathering data regarding near misses and actual adverse events experienced by patients for teaching, accreditation, and oversight purposes [1]. In 2005, the Joint Commission created a taxonomy for patients safety events with the aim to standardize the lexicon and facilitate incorporation and assessment of patient safety data over time [6].

10.1080/20009666.2018.1527670-F0003Figure 3.Improvement in safety events reporting with advancement in training: Percentage of respondents in different years of training who have reported a patient safety event.

…”

Die Patientensicherheit in der Schweiz

“…Somit ist es nicht klar, was verbessert werden soll, wie Verbesserungen gemessen und wie sie kommuniziert werden können. Verwertbare Grundlagen für einen Schweizer Definitionskatalog wären vorhanden [16]. Die evidenten Massnahmen zur Verbesserung der Patientensicherheit sind in einer Metaanalyse beschrieben worden [17] …”