How to use the Patient Harm Index (PHI) Scorecard The Patient Harm Index (PHI) rolls up all harmful events into a single score so the organization knows in an instant how it is doing.
Each patient harm event is assigned a value of 1. Rates and ratios are not used since the goal is “zero harm.”
Therefore, a PHI of zero would be the desired goal, as it would reflect that all harm was eliminated. In the converse, the higher the Index, the
worse the score, and the more harm patients suffered.
In the attached example of a 25-hospital system, the PHI is calculated as follows:
Step 1: Determine the total number of patient harming events in all system hospitals for 2014 by adding the total numbers of events under each
metric. (These are the numbers on the last row.) The total is 685. (Note that this system has chosen a very specific set of harm events that it
wishes to track. Your set of events will be different and will reflect your organization’s specific strategic goals. Your organization may have a fewer,
or greater, number of harm events it wishes to track.)
Step 2: Multiply this total (685) by the average Observed to Expected Mortality (O/E) ratio of 1.06. This yields a PHI score of 726.1. The O/E ratio
is a measure of the overall quality of care provided in each hospital and thus for the entire system. Hospitals with a ratio less than 1 are rewarded
in the calculation of their Index. Hospitals are penalized for ratios greater than 1.
Lowering either the absolute number of events, or the O/E ratio, lowers the PHI. Zero patient harming events system-wide multiplied by an
average O/E of 1, would yield a system PHI score of zero.
Using this system as a template, hospitals may compare units or service lines within the hospital, and/or systems can compare hospitals within the
system. Comparisons can be made month to month or year over year. A blank Excel spreadsheet template is available for download. Add your
specific patient harm metrics, and the numbers of events in each unit or hospital to create your customized PHI dashboard.
For even greater impact, hospitals may want to attach financial costs to each instance of patient harm. Doing so will allow senior leaders to know
how much each event costs the organization—and when improvements are made—the financial benefits of those improvements.
Questions on this scorecard may be addressed to Steve Harden at [email protected] or by calling 901.413.8598.
Zero Patient Harm Dashboard
Corp Quality All Facility Dashboard - NHSN
MIDAS
Reporting
Count of Occurrence
Count of Occurrence
* Hospital
* Hospital
Acquired
Acquired Stage
Accidental
III & IV
Punctures and
Pressure Ulcer
Laceration
Hospital
Acquired
Potentially
Preventable
VTE/PE
Foreign Body
Retained
Hospital
During a
Acquired Injury
Procedure
Risk Adjusted
Sepsis Pts that Observed/Expec
Progressed to
ted Mortality
Septic Shock
Ratio
Wrong Site
Surgery
Sepsis
Readmitted
within 30 Days
0
0
0
1
1.02
5
0
0
13
7
1.23
0
0
0
3
5
1.04
4
6
1
0
8
11
0.96
21
4
6
0
0
9
13
1.13
16
2
3
0
0
10
19
1.03
0
1
0
2
0
0
21
1
0.87
0
6
1
0
0
0
5
10
1.29
6
23
3
1
0
0
5
5
0.98
0
0
4
0
0
0
0
4
0
0.97
0
1
0
4
0
3
0
0
4
0
1.52
2
0
0
1
1
2
0
0
4
0
1.74
0
0
0
0
1
0
0
0
0
10
0
1.14
0
0
0
0
26
0
1
0
0
12
3
0.64
251
1
2
0
8
12
0
5
1
0
6
3
1.11
213
0
0
0
1
9
1
0
1
0
43
5
1.02
Available
Beds
* ICU
CLABSI
* ICU
CAUTI
Colon
SSI
A
177
0
0
0
0
9
0
5
B
293
0
0
0
7
10
0
C
104
0
0
1
0
6
1
D
237
0
0
0
1
21
E
450
1
2
1
3
F
320
0
2
0
3
G
233
no data
no data
no data
H
157
0
0
0
I
120
0
0
0
J
120
0
0
0
K
140
0
0
L
167
0
M
183
0
N
101
O
460
P
Q
Hospital
Ratio
0
0
no data
S
441
0
0
0
T
60
0
0
0
U
363
2
1
0
2
25
2
1
1
0
3
2
1.05
V
246
0
2
0
0
17
0
1
0
0
9
27
1.54
W
120
0
0
0
0
0
0
1
0
0
2
2
0.95
X
319
0
2
1
2
26
2
3
1
0
6
4
1.10
Y
233
2
1
0
1
6
1
4
0
0
3
9
0.66
6
14
4
34
244
22
49
5
0
180
127
1.06
R
Total
PHI = 726.1 (Total Events X O/E Mortality)
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