Deaths from adverse events are halved in Dutch hospitals

BMJ 2013; 347 doi: (Published 28 November 2013) Cite this as: BMJ 2013;347:f7147
  1. Tony Sheldon
  1. 1Utrecht

The number of deaths from adverse events in hospitals in the Netherlands has halved during a national five year programme to improve safety, show figures from the country’s latest survey of harm related to care.

Researchers from the Institute for Health Services Research (NIVEL) and Amsterdam’s Free University Medical Centre looked at 4000 admissions among a representative sample drawn from 20 of the Netherlands’ 91 hospitals.

The study found that the number of deaths related to failures in organisational or professional standards fell by just over half from 1960 in 2008 to 970 in 2011-12.1 This represents 2.6% of all hospital deaths, which compares with a UK figure for 2009 of 5.2%.

This “significant decrease” from the 2008 figure was achieved despite an increasingly complex mix of patients, owing to an ageing population.

The proportion of potentially preventable adverse events also fell over the same period, from 2.9% of all admissions in 2008 to 1.6% in 2011-12. Meanwhile, rates of adverse events in general caused by unforeseeable or unexpected complications remained static at about one in 14 patients.

The national safety improvement programme, launched in 2008, included a focus on infection prevention, targeted screening of vulnerable elderly patients, and extra checks on administration of high risk drugs.2

Although the study was not a randomised controlled trial and so proved no causal relation, the researchers argued that the reductions found in numbers of preventable adverse events in elderly and surgical patients fitted well with progress made in the use of checklists for these groups as part of the national patient safety programme. Though the figures are encouraging, concerns remain that nearly 1000 patients still die every year.

The study’s leader, Cordula Wagner, professor in patient safety at the Free University Medical Centre, said that the findings showed room for further improvement, such as use of anticoagulation in patients undergoing surgery and periodic training of health professionals in the application of medical equipment and devices. The national safety campaign needed to “develop continuously in order to anticipate new risks,” she said.


Cite this as: BMJ 2013;347:f7147


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