The key to improved patient and employee safety is increasing incident and event reporting to collect data to better understand process gaps and root causes of safety events. To ensure employees are engaged in the event reporting process, it’s essential that incident reporting forms be designed effectively.
Optimizing User Experience
When designing incident reporting forms, the first goal is for healthcare teams to be able to submit reports with just a few clicks, so that they can spend less time on administrative tasks and more time on patient care. One way to accomplish this is by prompting for key details rather than encouraging more open-ended responses.
An empirical study performed by Google of existing user experience guidelines for web form design concluded that improved web forms lead to faster completion times, fewer form submission attempts, and increased user satisfaction. According to the study, a well-designed reporting form meets the following general criteria:
- Form content: Forms should be short and intuitively ordered, allow flexibility in answers, and clearly distinguish between required and optional questions.
- Form layout: Fields for answers should be labeled above, listed one per row, and sized appropriately for the length of the answer.
- Input types: Menus, checkboxes, buttons, or open response fields are appropriate for different numbers and types of answers. Options should be in an intuitive order and limited in number if possible.
- Error handling: Answers should have their expected formats clearly indicated and should not be cleared by errors. Error messages should be polite, informative, embedded in the form, and easily noticed.
Identify Event Types
The Agency for Healthcare Research and Quality (AHRQ) developed Common Formats for the reporting and analysis of patient safety data.
AHRQ’s Common Formats are a set of standardized definitions and configurations that make it possible to collect, aggregate, and analyze uniformly structured information about patient safety for local, regional, and national learning.
The Common Formats give providers proven templates and guidelines to improve patient safety and quality within their organizations. The AHRQ Common Formats include the following:
- A common set of definitions of patient safety concerns that may give rise to patient harm and examples of patient safety reports
- Paper forms for versions prior to CFER-H V2.0 to guide the development of data collection instruments
- A users’ guide, which describes how to use the formats
To encourage widespread adoption and learning, AHRQ’s Common Formats are available in the public domain. That said, organizations will want to select events and categories most relevant to their specific needs, many of which may exceed the categories available through AHRQ.
AHRQ Common Formats for Event Reporting (CFER) define three types of events:
- Near misses: “Close calls” are patient safety events that did not reach the patient. An example of a near miss is a bed rail that is left in the unlocked position while occupied by a patient, but the patient does not fall from the bed as a result. These are the most common event types, accounting for 41 percent to 61 percent of known reported incidents.
- Adverse events: “Occurrences,” or what we’ve been calling “incidents,” are safety events that reached the patient, whether or not there was harm involved. An example of an incident is a patient fall.
- Unsafe conditions: These are circumstances that increase the probability of a patient safety event occurring. An example of an unsafe condition is a defective bed rail that is not repaired.
Identify Core Data Points on the Incident Reporting Form
To analyze large amounts of data in a meaningful way, incident reporting forms must be built and implemented in a standardized format.
For all events, there are common data points that need to be collected; these detail the type of patient safety concern, the circumstances of the event or unsafe condition, patient information (if applicable), and reporter information.
The following data points are built into every incident report form.
A. Circumstances of the Event
- Date and time of event
- Location of event (e.g., lab, procedure room, waiting room, pharmacy, etc.)
- Narrative description of event or unsafe condition
B. Patient Information
- Identifying information about the patient affected (e.g., date of birth, age range, sex, ethnicity, race)
- Degree of harm to the patient (e.g., adverse event, near miss)
C. Reporter Information
- Job or position (e.g., healthcare professional, healthcare worker, emergency service professional, patient, family member, volunteer, caregiver, etc.)
Create Main Event Categories
A patient safety committee, risk management, or quality team will determine the most common types of events that occur within an organization.
For example, common incidents and events for an FQHC might include falls, medication, injury, diagnostics, environmental concerns, security issues, compliance, employee safety, and patient relations.
Behavioral health centers might have special categories such as restraint/seclusion, self-harm, and elopement. And LTACs might prioritize infection and pressure ulcers.
Your organization may have all or a handful of common event categories such as:
- Falls: Assisted, unassisted
- Medication: Incorrect medicine, look alike or soundalike, med rec, pharmacy
- Compliance: Abuse, behavior, appropriateness of care, HIPAA
- Security: Aggressive/disruptive behavior, building not secure, property loss/damage
- Patient relations: Complaints and grievances
- Employee safety: Exposure, injury, abuse
- Infection control: Pneumonia, , bloodstream infection, surgical site infection,
- Equipment: Broken equipment, electrical shock, equipment malfunction, equipment not cleaned, lost equipment
- Environment of Care: Cleanliness, biohazardous waste, equipment, supplies, facility, trash, event
- Exposure: Airborne, needle stick, sharp injury, splash/spill
- Injury: Bump, bruise, abrasion, fracture
- Diagnostics: Incorrect test, notification delay, contaminated specimen
- Surgery/procedure: Accidental puncture, delay/cancellation, return to surgery, wrong patient, wrong site
- Mother/baby: Delayed delivery, injury, code transfer, precipitous delivery, newborn code
- Assessment: Wrong protocol, wrong assessment
Each type of event will have a unique question set and specific data points collected to identify trends through the incident reporting form.
It should be noted that no matter how well incident reporting forms are designed, organizations must also position incident reporting in a positive light. They must implement an incident management system by approaching the information collected in a nonpunitive way, essentially adopting a just culture of care.
When used in a setting in which everyone is actively working to support patient and employee safety, incident reporting software promotes accountability and facilitate the journey to zero harm.
Healthcare organizations have traditionally relied on paper-based incident reporting, which makes it difficult to translate fragmented data into meaningful insights for prevention.
Performance Health Partners’ digital incident reporting system was designed to facilitate and expedite the incident management process and comes equipped with incident reporting forms fully customizable to meet the needs of your organization. This equates to streamlined event management and empowers leaders to quickly measure and analyze recurring trends that suggest a course of action for preventing future incidents.
Want to learn more? Request a free demo with our team.