Strengths and weaknesses of case-finding tools
| Tool | Purpose | Key strengths | Key weaknesses |
| ICD-9-CM External cause of injury (E-codes) | Injury Surveillance and prevention | Standardised for international comparison; captures adverse drug reactions | Inconsistently used among hospitals; lack of clinical detail/context; variability in coding; inaccuracy |
| ICD-9-CM Nature of injury (N-codes) | Reimbursement | Routinely collected by all hospitals; easily acquired; standardised for international comparison | Lack of clinical detail/context; variability in coding; financial pressures for ‘upcoding’ or ‘downcoding’; inaccuracy |
| Patient Safety Indicators (PSI) | Screening hospital discharge data for patient safety events to improve provider performance | More precisely reflects exposure by restricting the denominator to exclude patients whose pre-existing conditions would probably lead to PSI events regardless of error; international utility | Includes only 20 narrowly defined patient safety outcomes; does not capture falls or adverse drug reactions |
| Voluntary reporting (PSN) | Identifying medical errors | Encompasses all possible errors and near misses; captures both falls and medication errors | Low reporting rate; non-representative sample |
PSN, Patient Safety Net.