The Agency for Healthcare Research and Quality (AHRQ) coordinates the development of Common Formats for reporting patient safety events to Patient Safety Organizations (PSOs). This activity is authorized by the Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act) and the Patient Safety and Quality Improvement Final Rule (Patient Safety Rule). In collaboration with the interagency Federal Patient Safety Workgroup (PSWG), the National Quality Forum (NQF) and the public, AHRQ has developed Common Formats for two settings of care — acute care hospitals and skilled nursing facilities.
What Are Common Formats?
The term "Common Formats" refers to the common definitions and reporting formats that allow health care providers to collect and submit standardized information regarding patient safety events. Additional details about the conceptual framework for the content and structure of the Common Formats can be found at http://www.pso.ahrq.gov/formats/eventdesc.htm.
The Common Formats apply to all patient safety concerns, including:
AHRQ's Common Formats include:
The technical specifications promote standardization of collected patient safety event information by specifying rules for data collection and submission, as well as by providing guidance for how and when to create data elements, their valid values, conditional and go-to logic, and reports. These specifications will ensure that data collected by PSOs and other entities have comparable clinical meaning. They also provide direction to software developers, so that the Common Formats can be implemented electronically, and to PSOs, so that the Common Formats can be submitted electronically to the PPC for data de-identification and transmission to the Network of Patient Safety Databases (NPSD).
The Common Formats include two general types of formats, generic and event-specific. The generic Common Formats pertain to all patient safety concerns. The three generic formats are: Healthcare Event Reporting Form, Patient Information Form, and Summary of Initial Report. These formats are paired with event-specific Common Formats pertaining to frequently occurring and/or serious patient safety events. When used as designed, the Common Formats allow collection of information on all harms to patients: “all-cause harm.” To see the full list of event-specific formats for both the acute care hospital and skilled nursing facility settings, go to the PPC Web site.
Future versions of the Common Formats are being developed for ambulatory settings, such as ambulatory surgery centers, and physicians' and practitioners' offices.
How Does AHRQ Develop the Common Formats?
AHRQ convenes the PSWG to assist AHRQ with developing and maintaining the Common Formats. The PSWG includes major health agencies within the Department of Health and Human Services (HHS)—the Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Food and Drug Administration (FDA), Health Resources and Services Administration, Indian Health Service (IHS), National Institutes of Health, National Library of Medicine, Office of the National Coordinator for Health Information Technology (ONC), Office of Public Health and Science, and Substance Abuse and Mental Health Services Administration—as well as the Department of Defense (DoD) and Department of Veterans Affairs (VA).
When developing Common Formats, AHRQ first reviews existing patient safety event reporting systems from a variety of health care organizations (select for list). In collaboration with the PSWG and Federal subject matter experts, AHRQ drafts and releases beta versions of the Common Formats for public review and comment.
Through a contract with AHRQ, NQF solicits feedback on each version of the Common Formats from private sector organizations and individuals. The NQF, a nonprofit organization that focuses on health care quality, then convenes an expert panel to review the comments received and provide feedback. Based upon the expert panel's feedback, AHRQ, in conjunction with the PSWG, further revises the Common Formats.
Most recently, AHRQ and the PSWG developed Common Format—Readmissions Version 0.1 Beta, to allow hospitals to aggregate data that describe circumstances associated with the readmission of patients. These factors include: actions taken during the index hospitalization (or at discharge) to prevent a readmission; risk factors for readmission; length of stay; presence of an adverse event; location of discharge setting; as well as other attributes. Using this standardized method of review, hospitals can identify factors associated with unnecessary readmissions. In addition, hospitals can compare their data to others and analyze trends on a community, regional, and national level. Common Format–Readmissions Version 0.1 Beta (dated July 2012), is currently available for public review at www.psoppc.org.
How Will the Data Be Used?
The most important use of the Common Formats is to support local quality improvement activities, as both the Common Formats individual event summary and aggregate reports can provide immediate feedback at the provider level. In addition, the Common Formats can be used to report to relevant external entities, including PSOs, the NPSD (as authorized by the Patient Safety Act), accrediting bodies, and institutions with reporting requirements. AHRQ will use data collected from the NPSD to analyze national and regional patient safety event statistics, including trends and patterns. Findings are to be made public and included in AHRQ's annual National Healthcare Quality Report.
How Will AHRQ Continue To Refine the Common Formats?
AHRQ is committed to continuing refinement of the Common Formats. The Agency is specifically interested in obtaining feedback from both the private and public sectors—particularly from those who use the Common Formats—to guide their improvement.
Where Can I Find the Common Formats?
The most recent versions of the Common Formats are available on the PSO PPC Web site.
How Can I Comment on the Common Formats?
To provide feedback on the Common Formats, go to the National Quality Forum (NQF) Web site for Common Formats.