The Agency for Healthcare Research and Quality (AHRQ) coordinates the development of Common Formats for reporting and analysis of patient safety data. 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). A major goal of the legislation is to allow aggregation of data to identify and address underlying causal factors affecting patient quality and safety. This legislation also called for the establishment of Patient Safety Organizations (PSOs) and a Network of Patient Safety Databases (NPSD) to aggregate and analyze patient safety data.
For more information on PSOs, the Patient Safety Act, and the Patient Safety Rule, please see AHRQ's PSO website: http://pso.www.ahrq.gov/.
In collaboration with the Federal Patient Safety Workgroup (PSWG), the National Quality Forum (NQF), and the public, AHRQ has developed Common Formats for three settings of care - hospitals, community pharmacies and nursing homes.
There are currently three types of Hospital Common Formats: Common Formats for Event Reporting, Common Formats for Readmission, and Common Formats for Surveillance. After completing a review of the existing patient safety reporting systems from a variety of health care organizations, AHRQ developed, piloted, drafted, and released Common Formats for Event Reporting - Hospital Version 0.1 Beta (CFER-H V0.1 Beta) in August 2008.
AHRQ further collaborated with NQF to solicit feedback on CFER-H V0.1 Beta from private sector organizations and individuals. Based on the NQF's feedback, AHRQ in conjunction with PSWG further revised the CFER-H V0.1Beta and released Common Formats for Event Reporting - Hospital Version 1.0 (CFER-H V1.0) in September 2009.
The review process was repeated to refine the Hospital Common Formats and incorporate public comments on Version 1.0, prior to finalizing the technical specifications for electronic implementation. Those modified formats for acute care hospitals were made available as Common Formats for Event Reporting - Hospital Version 1.1 (CFER-H V1.1) in March of 2010 and included the event-specific modules of Blood or Blood Product; Device or Medical/Surgical Supply; Fall; Healthcare-associated Infection (HAI), Medication or Other Substance; Perinatal; Pressure Ulcer; and Surgery or Anesthesia. In April 2012, AHRQ rolled out Common Formats for Event Reporting - Hospital Version 1.2 (CFER-H V1.2), which featured the new event-specific module Venous Thromboembolism (VTE) and revised the Device or Medical/Surgical Supply module to capture patient safety concerns associated with Health Information Technology (HIT) devices. The CFER-H V1.2 includes the event descriptions, sample reports, and forms for both generic and event-specific categories. The Generic Hospital Common Formats forms include the Healthcare Event Reporting Form (HERF), Patient Information Form (PIF), and Summary of Initial Report (SIR), and specify information that is to be collected pertaining to all patient safety concerns. The event-specific categories for CFER-H V1.2, allow the collection of structured information for the following patient safety concerns: Blood or Blood Product; Device or Medical/Surgical Supply, including HIT; Fall; Healthcare-associated Infection (HAI); Medication or Other Substance; Perinatal; Pressure Ulcer; Surgery or Anesthesia; and VTE.
Common Formats for Event Reporting - Hospital Version 2.0a (CFER-H V2.0a) constitutes a major release of the AHRQ Common Formats. CFER-H V2.0a incorporates new and modified content and technical specifications revised since the release of CFER-H V1.2 in April 2012. CFER-H V2.0a represents an overall decrease in scale from CFER-H V1.2 to reduce reporting burden. CFER-H V2.0a consolidates the Healthcare Event Reporting Form (HERF), Patient Information Form (PIF), and Summary of Initial Report (SIR) into one module, called the Generic module. This version also eliminates paper forms to encourage electronic reporting of patient safety concerns, and designates a set of Core content required for event reporting, by providers to PSOs and by PSOs to the PSOPPC for national aggregation and analysis.
In July 2012, Common Formats - Readmissions - Hospital Version 0.1 Beta was released to allow hospitals to aggregate data and analyze readmission attributes. The Readmissions module is primarily designed for use in the acute care hospital environment to gain enhanced understanding about the circumstances surrounding readmissions. These formats can be used within a hospital or healthcare system and may assist hospitals in response to the Affordable Care Act Hospital Readmissions Reduction Program.
In February 2014, AHRQ released Common Formats for Surveillance - Hospital Version - 0.1 Beta, which also includes both generic and event-specific categories. The event-specific categories for patient safety surveillance included in the Beta version are Blood or Blood Product; Delivery-Maternal; Delivery-Neonatal; Device or Medical/Surgical Supply, including HIT; Fall; Medication; Pressure Ulcer; Readmission; Surgery or Anesthesia; VTE, and Other Outcomes of Interest. Common Formats for Surveillance - Hospital are designed to provide through retrospective review of medical records, information that is complementary to that derived from event reporting systems. These formats facilitate improved detection of events and calculation of adverse event rates in populations reviewed.
AHRQ released the Common Formats for Event Reporting - Nursing Home Version 0.1 Beta (CFER-NH V0.1 Beta) in March 2011, including event descriptions, sample reports, and forms for generic and event-specific categories. The generic categories of the CFER-NH V0.1 Beta include the HERF, PIF, and SIR, which pertain to all patient safety concerns. The event-specific categories are the Device or Supply, including HIT; Fall; HAI; Pressure Ulcer; and Medication or Other Substance modules.
AHRQ released the Common Formats for Event Reporting - Retail Pharmacy Version 0.1 Beta in October 2015. AHRQ worked with the NQF based on the public review and comment received, and developed and released the Common Formats for Event Reporting - Community Pharmacy Version 1.0 (CFER-CP V1.0) in December 2016. The CFER-CP V1.0 module is designed for use in the community pharmacy environment to gain enhanced understanding about the circumstances surrounding patient safety data in the community pharmacy setting. This module is self-contained, covering everything necessary to report patient safety data in the Community Pharmacy event-specific category.
Patient Safety Concerns include any circumstance involving patient safety, and encompasses patient safety events (both incidents and near misses) and unsafe conditions.
Additionally, Common Formats for Event Reporting - Community Pharmacy 1.0 (CFER-CP V1.0) is active for reporting, implementation, and use by community pharmacies and PSOs.
Only active versions of the Common Formats are accepted by the Patient Safety Organization Privacy Protection Center (PSOPPC). Comments may be submitted for all active reporting versions through the NQF Common Formats website.
CFER-H V1.2, released in April 2012, incorporates all of the content updates made to the Common Formats and includes full technical specifications for electronic implementation.
CFER-H V2.0a, released in August 2018, incorporates all new and modified content applied to the Common Formats for Hospitals and provides full technical specifications and supporting documentation for implementation.
CFER-CP V1.0, released in December 2016, is the first version of Common Formats for the Community Pharmacy setting.
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