A key indicator in the emergence of a strong reporting culture is the move away from a paper or homegrown event reporting tool to a more robust electronic system that supports real-time reporting, methodical tracking, and in-depth analysis of adverse events. While the benefits of transitioning to a robust electronic application will certainly outweigh any barriers, stepping away from what’s comfortable can be a challenge. Here are a few reassuring observations that several Risk Managers shared soon after transitioning to American Data Network’s electronic patient safety event reporting system:
- More events are being reported. A well-designed event reporting system with a straightforward click-through experience can spark a steady rise in the number of events reported. One rural, acute care facility saw a 33% increase in the number of incidents logged within 12 months of implementing ADN’s application. The Risk Manager noted an upswing in reports coming from ancillary departments including Radiology, ED, and Home Health as well as a wider variety of event types now being recognized as reportable occurrences.
- I’m learning about events in real time. With paper reporting, there’s a natural lag between when an event gets reported and when the Risk Manager finds out about it. Sometimes that gap is a week or even two weeks, and the Risk/Safety Department is the last to know. Electronic reporting with auto-notifications ensures that the Risk Manager and other designated supervisors receive immediate alerts when an event is logged.
- Formalization of the follow-up process is transformational. Because managers are notified as soon as an event is logged, investigation can start the same day instead of days after an occurrence. Assigning follow-up is quick and often includes multidisciplinary participation which can easily be delegated and monitored in the manager’s work queue. Built-in email notifications make it easy to send reminders through the system to nudge investigators to complete follow-up assignments.
- Managers have more ownership in the process. An electronic system offers a centralized space for communication about incidents, near misses, and unsafe conditions discovered facility-wide. Transparency affords department and event managers a new perspective from which it’s easier to take the reins and coordinate the efforts of everyone involved with a particular event no matter where they work in the facility. The Risk Manager is able to monitor, in tandem, steps taken to address reported events.
- Running reports isn’t as stressful as it used to be. When using paper tools, analyzing and sharing adverse event data is tedious and time-consuming. Conversely, with an electronic system, real-time reports are available and offer drill-downs to provide context around data that makes it easy to spot improvement opportunities. Simply selecting dates and other preferred parameters dramatically reduces prep time and the stress associated with generating reports for committees, leadership and board meetings. In one instance at a 130-bed facility, running ADN’s prebuilt reports freed up a staff member, who historically spent a minimum of two days per week manually and feverishly transcribing event summaries for committee meetings.
- We’re capturing higher quality data. Truth be told: while electronic reporting is extremely easy to do, it can take a couple of minutes longer than the paper forms staff are used to, but that’s because the system is collecting high-value, discrete data. A system with skillfully integrated skip logic ensures a timely reporting process seeking only the most relevant data elements associated with a specific event. It’s important that staff understand that every piece of data entered can be analyzed and used to inform decisions that will help improve care.
- Support from senior leadership is vital. Staff embrace electronic reporting more fervently when leadership support is clear and grounded by a commitment to a Just Culture. Trust builds and reporting blossoms when staff view their participation as central to the facility’s Culture of Safety. A stellar example of undeniable support is the leadership team at an 11-hospital system that awarded a day off to each quarterly winner during their Good Catch Campaign steered by ADN Patient Safety Organization.
About American Data Network
For more than 24 years, American Data Network (ADN), which is also the parent company to its Patient Safety Organization (ADNPSO), has worked with large data sets from various sources, aggregating and mining data to identify patterns, trends and priorities within the clinical, financial, quality and patient safety arenas.3 ADN developed the Patient Safety Incident Reporting (QAC) application, with which hospitals, clinics, rehabs, and other providers record and manage patient safety events. By entering events into ADN’s QAC application and submitting them to the PSO, information is federally protected and thereby privileged and confidential. These protections provide a safe harbor to learn from mistakes and improve patient safety.