Table 2

Effect sizes of patient-safety interventions: results from meta-analyses (n=30) reported in the 60 included systematic reviews

Patient-safety area	Reference meta-analysis	Intervention	Patient outcome	Effect size (95% CI) significant effect sizes are bold	p Value	Studies in meta-analysis (n) (eligible studies* (n))
Adverse drug event Medication review	Holland et al24	Pharmacist-led medication review	Mortality	RR 0.96 (0.82 to 1.13)	0.62	22
	Christensen and Lundh26	Medication review	Mortality	RR 0.98 (0.78 to 1.23)	0.86	4
	Hohl et al27	Medication review	Mortality	OR 1.09 (0.69 to 1.72)	0.71	3
Adverse drug event Computerised advice on drug dosage	Durieux et al28	Computerised advice on drug dosage	Mortality	RR 0.81 (0.37 to 1.81)	0.61	6
	Gillaizeau et al29	Computerised advice on drug dosage	Mortality	RR 1.08 (0.80 to 1.45)	0.61	10
	Bayoumi et al30	Computerised drug-laboratory alerts	Adverse events (bleeding and thrombosis)	OR 0.88 (0.78 to 1.00)	0.05	4
Adverse drug event Multicomponent interventions	Davey et al33	Intervention for antimicrobial therapy	Mortality	RR 0.92 (0.69 to 1.22)	0.56	3
		Antibiotic guideline for pneumonia	Mortality	RR 0.89 (0.82 to 0.97)	0.01	4
		Decrease excessive prescribing	Mortality	RR 0.92 (0.81 to 1.06)	0.25	11
	Wang et al36	Pharmacist interventions	Preventable adverse drug events	OR 0.23 (0.11 to 0.48)	<0.01	3 (2)
Infections	Blot et al39	Care bundle/checklist interventions	CLABSI	OR 0.39 (0.33 to 0.46)	<0.01	41 (5)
	Blot et al39	Care bundle/checklist interventions	CLABSI rate at 3 months	OR 0.30 (0.10 to 0.88)	0.03	6 (4)
	Meddings et al40	Catheter reminder and stop order	CAUTI episodes per 1000 catheter days	RR 0.47 (0.30 to 0.64)	<0.01	11 (1)
	Meddings et al40	Catheter reminder and stop order	CAUTI	RR 0.72 (0.52 to 0.99)	0.05	8 (2)
	Damiani et al41	Sepsis bundle	Mortality	OR 0.66 (0.61 to 0.72)	<0.01	48 (3)
Delirium	Hempenius et al47	Multicomponent interventions, including cognitive screening, proactive geriatric consultation and psychotherapy	Incidence of delirium	OR 0.58 (0.38 to 0.92)	NR	5
	Hempenius et al47	One-component interventions	Incidence of delirium	OR 1.05 (0.09 to 11.57)	NR	2
	Hshieh et al50	Multicomponent intervention, including early mobility, cognition and orientation	Incidence of delirium	OR 0.47 (0.38 to 0.58)	<0.01	11 (7)
	Martinez et al51	Multicomponent intervention, including physiotherapy, daily reorientation, family involvement and staff/family-member education	Incidence of delirium	RR 0.73 (0.63 to 0.85)	<0.01	7
Adverse event after hospital discharge or clinical handover	Griffiths et al52	Nursing-led inpatients units	Mortality	OR 1.10 (0.56 to 2.16)	0.64	7
	Griffiths et al52	Nursing-led inpatients units	Mortality 3 or 6 months post admission	OR 0.96 (0.63 to 1.47)	0.62	6
	Conroy et al53	Comprehensive geriatric assessment	Mortality	RR 0.92 (0.55 to 1.52)	0.77	5
	Niven et al54	Critical-care transition programmes	Mortality	RR 0.84 (0.66 to 1.05)	0.1	3 (2)
	Shepperd et al56	Discharge planning from hospital to home	Mortality at 6–9 months	RR 1.00 (0.79 to 1.26)	0.69	6
	Shepperd et al56	Discharge planning from hospital to home	Falls	RR 0.87 (0.50 to 1.49)	0.61	1
	Lowthian et al57	Optimised ED discharge	Mortality up to 18 months postdischarge	OR 1.01 (0.70 to 1.47)	0.94	2
	Zhu et al58	Nurse-led early-discharge planning	Mortality	RR 0.70 (0.52 to 0.95)	0.02	5
Fall	Oliver et al59	Multicomponent intervention	Falls	RaR 0.82 (0.68 to 1.00)	NR	12
			Fallers	RR 0.95 (0.71 to 1.27)	NR	12
			Fractures	RaR 0.59 (0.22 to 1.58)	NR	12
	Coussement et al60	Multicomponent intervention	Falls	RR 0.82 (0.65 to 1.03)	NR	4
	Coussement et al60	Multicomponent intervention	Number of fallers	RR 0.87 (0.70 to 1.08)	NR	4
	Cameron et al61	Multicomponent interventions	Rate of falls	RaR 0.69 (0.49 to 0.96)	0.03	4
		Multicomponent interventions	Risk of falling	RR 0.71 (0.46 to 1.09)	0.12	3
		Exercises	Risk of falling	RR 0.36 (0.14 to 0.93)	0.04	2
Adverse event in surgery	Bergs et al66	WHO surgical safety checklist	Any complication	RR 0.59 (0.47 to 0.74)	<0.01	5
			Mortality	RR 0.77 (0.60 to 0.98)	0.04	4 (3)
			Surgical-site infections	RR 0.57 (0.41 to 0.79)	<0.01	5
Cardiopulmonary arrest	Chan et al69	Rapid response team	Mortality	RR 0.92 (0.82 to 1.04)	NR	16
	Chan et al69	Rapid response team	Cardiopulmonary arrest	RR 0.65 (0.55 to 0.77)	NR	16
	Maharaj et al71	Rapid response team	Mortality	RR 0.91 (0.85 to 0.97)	<0.01	4
	Maharaj et al71	Rapid response team	Cardiopulmonary arrest	RR 0.74 (0.56 to 0.98)	0.04	2
Venous thromboembolism	Kahn et al72	Alerts	All venous thromboembolism	RR 0.85 (0.49 to 1.46)	NR	3
		Multicomponent interventions	All venous thromboembolism	RR 1.01 (0.51 to 1.98)	NR	5
		Multicomponent interventions	Symptomatic deep vein thromboembolism	RR 0.59 (0.18 to 1.98)	NR	3
Staffing	Butler et al75	Addition of specialist nursing post to staffing	In-hospital mortality	RR 0.96 (0.59 to 1.56)	0.86	1
		Addition of specialist nursing post to staffing	Postdischarge adverse events	RR 1.03 (0.70 to 1.53)	0.87	1
		Increasing the proportion of support staff	Mortality in trauma unit	RR 0.41 (0.16 to 1.01))	0.05	1
			Mortality in hospital	RR 0.56 (0.29 to 1.09)	0.09	1
			Mortality at 4 months	RR 0.57 (0.34 to 0.95)	0.03	1
	Pannick et al76	Interdisciplinary teams	Mortality	wRR 0.92 (0.82 to 1.05)	NR	7
	Pannick et al76	Team practice interventions	Mortality	wRR 0.67 (0.45 to 0.99)	NR	2
Clinical pathway	Rotter et al79	Clinical pathway	Mortality	OR 0.84 (0.64 to 1.11)	0.23	3
			Complications up to 3 months	OR 0.31 (0.13 to 0.72)	0.07	1
			In-hospital complications	OR 0.58 (0.36 to 0.94)	0.03	5

*Study design in accordance with methodological criteria of the Cochrane EPOC review group and quantitative data on adverse event rates were reported.
CAUTI, catheter-associated urinary tract infection; CLABSI, central-line-associated bloodstream infection; EPOC, Effective Practice and Organisation of Care; NR, not reported; RaR, rate ratio; RR, risk/relative ratio; wRR, weighted risk ratio.