Reporting systems in healthcare from a case-by-case experience to a general framework: an example in anaesthesia

Abstract

SummaryReporting systems are becoming more widespread in healthcare. Since they may become mandatory under the pressure of insurance companies and administrative organizations, it is important to begin to go beyond a case-by-case approach and to move to a system where there is a general reflection on the best conditions of development and setting up of such systems in medicine. In this paper, we review existing reporting systems, break down their components, examine how they are constructed and propose some ideas on how to articulate them in a dynamic process in order to improve the validity of the tool as mediator of safety, quality and well-being at work. Following their development in industrial and aviation areas, accident reporting systems are becoming more widespread in healthcare. The intention behind their implementation is to systematically collate and analyse the risks associated with medical activities in order to propose remedial and preventative actions. Several factors can explain the expansion of such systems in the medical sector. First, the progress of technology in general together with the development of increased technology in medicine itself have shed light on the role played by human errors in medical accidents. Reporting systems therefore first focused on the identification of patient injuries attributable to human errors. Second, the relationships between doctors and patients have changed and the public has been calling for clearer information concerning the risks associated with medicine. Third, litigation for medical negligence has increased to such an extent in many English-speaking countries that insurance companies, administration organizations and state health ministries have pressed for the development of strategies that can proactively prevent injuries. Professional organizations also have played a role in the development of reporting systems. Fearing medico-legal consequences, doctors and hospital staff have started to become aware of the need to change the myth of an error-free system in medicine and see in reporting systems one means to change culture and attitude towards human errors.In a recent report produced by the Quality of Health Care in America project [1], different existing reporting systems in medicine were reviewed. They varied according to a number of features. Some systems were mandatory by internal or external structures, whereas others were voluntary and confidential. Some systems focused on adverse patient injuries while others were extended to any event which could have, or did harm, anyone in the hospital, including

Toward viable information security reporting systems

“…In the face of economic pressures to produce, incident reporting may be seen as unnecessarily stealing time. For example, the form to be filled out may (Nyssen et al, 2004), or the reporter may have to participate in lengthy investigations (Phimister et al, 2003).…”