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Open Access Project Note

Design of a medical record review study on the incidence and preventability of adverse events requiring a higher level of care in Belgian hospitals

Annemie Vlayen1*, Kristel Marquet1, Ward Schrooten12, Arthur Vleugels13, Johan Hellings14, Elke De Troy15, Frank Weekers5 and Neree Claes1

Author Affiliations

1 Hasselt University, Faculty of Medicine, Patient Safety Group, Agoralaan Building D, Room D58, Diepenbeek 3590, Belgium

2 Ziekenhuis Oost-Limburg, Schiepse Bos 6, Genk, 3600, Belgium

3 Centre for Health Services and Nursing Research, K.U.Leuven, Kapucijnenvoer 35/4, Leuven, 3000, Belgium

4 ICURO, Handelstraat 82, Brussels, 1040, Belgium

5 Jessa Ziekenhuis, Stadsomvaart 11, Hasselt, 3500, Belgium

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BMC Research Notes 2012, 5:468  doi:10.1186/1756-0500-5-468

Published: 29 August 2012



Adverse events are unintended patient injuries that arise from healthcare management resulting in disability, prolonged hospital stay or death. Adverse events that require intensive care admission imply a considerable financial burden to the healthcare system. The epidemiology of adverse events in Belgian hospitals has never been assessed systematically.


A multistage retrospective review study of patients requiring a transfer to a higher level of care will be conducted in six hospitals in the province of Limburg. Patient records are reviewed starting from January 2012 by a clinical team consisting of a research nurse, a physician and a clinical pharmacist. Besides the incidence and the level of causation and preventability, also the type of adverse events and their consequences (patient harm, mortality and length of stay) will be assessed. Moreover, the adequacy of the patient records and quality/usefulness of the method of medical record review will be evaluated.


This paper describes the rationale for a retrospective review study of adverse events that necessitate a higher level of care. More specifically, we are particularly interested in increasing our understanding in the preventability and root causes of these events in order to implement improvement strategies. Attention is paid to the strengths and limitations of the study design.

Medical errors; Adverse events; Medical records; Medical audit; Intensive care units; Hospitals