The AusPSIs: the Australian version of the Agency of Healthcare Research and Quality patient safety indicators

Many countries are seeking ways to measure the safety and performance of their health systems. The ability to track improvement and monitor safety event rates at a population level is provided by routinely collected administrative data in conjunction with a set of well-developed indicators such as the patient safety indicators from the Agency for Healthcare Research and Quality (AHRQ) in the United States of America. These indicators are currently in the International Classification of Diseases Ninth Revision, Clinical Modification (ICD-9-CM) whereas Australia has coded its data in ICD-10-Australian Modification (ICD-10-AM) since 1998. We describe the process recently undertaken to translate and revise the patient safety indicators (PSIs) so they can be of use with ICD-10-AM. The initial translation (electronic mapping, review and revision by expert coder, programming of codes and testing on data from 1996-1998 ICD 9-CM to 1998-2006 ICD-10-AM, through 4 editions) found that differences between ICD-9-CM and ICD-10-AM datasets presented some challenges. After this phase, which was faithful to AHRQ's case definitions, the indicators were refined for use with the condition onset flag, resulting in the AusPSIs.