In the "study outcomes" section, a measurement is described as follows: "two physician investigators classified each suspected incident as an adverse event, a near miss or error with little potential for harm, or an exclusion." what study construct does this measure?
study outcomes medical errors and adverse events
we used a well-established surveillance process to measure our two-component primary outcome: rates of medical errors (preventable failures in processes of care) and preventable adverse events (unintended consequences of medical care that lead to patient harm). we also assessed nonpreventable adverse events, which were not expected to change after the intervention. at each site, a research nurse reviewed all medical records and orders on the study unit 5 days per week (monday reviews included a review of the weekend), formal incident reports from the hospital incident-reporting system, solicited reports from nurses working on the study unit, and daily medical-error reports from residents, collected through daily postshift surveys. two physician investigators who were unaware of whether a given incident occurred before or after the intervention classified each suspected incident as an adverse event (i. e., harm due to medical care), a near miss or error with little potential for harm, or an exclusion (i. e., an incident determined to be neither a medical error nor an adverse event) (70% agreement; kappa, 0.47; 95% confidence interval [ci], 0.44 to 0.50). physician reviewers further classified all adverse events as preventable (i. e., due to a medical error) or nonpreventable (i. e., due to a medical intervention with no error in the medical care delivery process) (72% agreement; kappa, 0.44; 95% ci, 0.36 to 0.52). discordant classifications were reconciled by discussion between the paired reviewers. examples of errors and events are provided in tables s2a and s2b in the supplementary appendix.
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