Hiatt et al developed screening criteria for use during chart reviews to help identify possible medical adverse events. This can help identify patients who should have a more complete review. The authors are from Harvard Schools of Public Health, Medicine and Law and Syracuse University.
Admission, discharge and transfer:
(1) recent previous hospitalization (within 1 year if < 65 years of age; within 6 months if >= 65 years)
(2) admission to any hospital after discharged for this admission
(3) transfer to the intensive care unit from a general ward
(4) transfer to another acute care hospital
(5) return to the operating room during this admission
(6) longer than normal length of hospital stay for diagnosis-related group (> 90th percentile if < 70 years of age; > 95th percentile if >= 70 years of age)
Adverse events during this admission:
(1) trauma incurred in the hospital
(2) unfavorable drug reaction in the hospital
(3) unintended organ damage after an invasive procedure
(4) acute myocardial infarction, cerebrovascular accident, or pulmonary embolus during or after an invasive procedure
(5) cardiac or respiratory arrest while in the hospital
(6) complication of abortion or labor and delivery
(7) other undesirable outcome
(8) death
Other findings:
(1) previous failure or unfavorable result of medical management
(2) indication of litigation in the medical record
(3) neurologic deficit at discharge (presumably absent on admission)
(4) if newborn, 5 minute Apgar score < 6
(5) temperature > 38.3°C on the day before discharge or on the day of discharge
Additional criteria (my additions):
(1) leaving the hospital against medical advice
(2) involved in an equipment failure
(3) nosocomial infection
(4) adverse reaction to blood product transfusion
