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 safety and quality. 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.
As part of the agency's efforts to improve diagnostic safety and quality in healthcare, AHRQ is in the process of developing Common Formats for Event Reporting - Diagnostic Safety (CFER-DS). The CFER-DS is intended to help healthcare providers identify and report missed opportunities in the diagnostic process in a standardized manner across healthcare settings and specialties. Widespread use of the CFER-DS will make it possible to collect, aggregate and analyze diagnostic safety-related information from healthcare providers across the country, which in turn can accelerate learning in this vital area of patient safety. After review by the PSWG (anticipated by early 2021), the proposed CFER-DS will be posted for public comment and reviewed by an expert panel with the assistance of the NQF. The initial version of the CFER-DS will be released upon completion of the development and review process.
After completing a review of the existing patient safety reporting systems from a variety of health care organizations, AHRQ developed, piloted, and released Common Formats - Hospital Version 0.1 Beta (CF-H V0.1 Beta) in August 2008. Using feedback obtained from both private sector and individuals, AHRQ released CFER-H V1.0 in September 2009.
Further refinements were made to the Hospital Common Formats, incorporating public comments on Version 1.0, which led to the creation of Common Formats for Event Reporting - Hospital Version 1.1 (CFER-H V1.1) in March 2010. In April 2012, AHRQ rolled out Common Formats for Event Reporting - Hospital Version 1.2 (CFER-H V1.2), which included event descriptions, sample reports, and forms for both generic and event-specific categories. The Generic Hospital Common Formats forms included the Healthcare Event Reporting Form (HERF), Patient Information Form (PIF), and Summary of Initial Report (SIR), and specified collected information pertaining to all patient safety concerns. The event-specific categories for CFER-H V1.2 allowed the collection of structured information across several patient safety concerns.
Common Formats for Event Reporting - Hospital Version 2.0 (CFER-H V2.0) constituted a major release of the AHRQ Common Formats. CFER-H V2.0, published in May 2017, incorporated new and modified content as well as technical specifications revised since the release of CFER-H V1.2. CFER-H V2.0 represented an overall decrease in scale from CFER-H V1.2 to reduce the reporting burden. CFER-H V2.0 consolidated the HERF, PIF, and SIR forms into one module, called the Generic module. This version also eliminated paper forms to encourage electronic reporting of patient safety concerns. Additionally, Core vs. Supplemental data elements were defined, with Core being content required for event reporting to the PSOPPC for national aggregation and analysis, and Supplemental being for optionally collected data by providers for additional analysis that could be reported to the PSOs but would not be accepted by the PSOPPC for national aggregation and analysis. In August 2018, CFER-H V2.0a was released with minor technical changes.
Common Formats for Event Reporting - Hospital release timeline:
In February 2014, AHRQ released Common Formats for Surveillance - Hospital Version 0.1 Beta (CFS-H V0.1 Beta), which includes both generic and event-specific categories. The event-specific categories for patient safety surveillance in CFS-H are designed to provide information that is complementary to that derived from event reporting systems through retrospective review of medical records. These formats facilitate improved detection of events and calculation of adverse event rates in populations reviewed. In November 2019, AHRQ released Common Formats for Surveillance - Hospital Version 0.3 Beta (CFS-H V0.3 Beta), which added the Hospital Acquired Condition (HAI)-Other along with the existing HAIs. An HAI-Other event is an infection other than those HAIs identified in the specific HAI Event Descriptions (EDs).
AHRQ released the Common Formats - Nursing Home Version 0.1 Beta (CF-NH V0.1 Beta) in March 2011, including event descriptions, sample reports, and forms for generic and event-specific categories. Based on the feedback received through public comments and consultation with various stakeholders in August 2019, AHRQ released Common Formats for Event Reporting - Nursing Home Version 1.0 (CFER-NH V1.0), which allows Patient Safety Organizations (PSOs) or vendors to submit patient safety concerns to the PSOPPC and to the Network of Patient Safety Databases (NPSD).
AHRQ released the Common Formats - 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.
Only active versions of the Common Formats are accepted by the Patient Safety Organization Privacy Protection Center (PSOPPC).
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 V2.0, released in May 2017, incorporates all new and modified content applied to the Common Formats for Hospitals and provides full technical specifications and supporting documentation for implementation. A minor technical release (CFER-H V2.0a) was implemented in August 2018.
Both CFER-H V1.2 and CFER-H V2.0 are active for reporting to the PSOPPC and for implementation and use by healthcare providers in hospitals and PSOs.
CFER-CP V1.0, released in December 2016, is the first version of Common Formats for the Community Pharmacy setting and is active for reporting, implementation, and use by community pharmacies and PSOs.
CFER-NH V1.0, released in August 2019, is the first version of Common Formats for Nursing Home setting and is active for reporting, implementation, and use by nursing homes and PSOs.
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