Are You Ready to Move from Fear-Free to Blame-Free Healthcare Incident Reporting?
It’s no secret that incident reports are a great means of improving patient safety. And the more incident reports, the better. After all, you can only learn from the mistakes that you know about.
The biggest barrier to reporting incidents is usually fear – fear that the person reporting the incident will be held accountable and their performance record will suffer. Anonymous reporting can go a long way toward quelling these fears. Over time, however, the need for this protection often diminishes as people get comfortable with the process and see results. At that point, you may want to consider taking the next step – blame-free incident reporting.
With blame-free incident reporting, reporters are willing – even eager – to be named in the interest of improving patient safety. This allows you to go back to the source for clarification or augmentation, which makes the information significantly more valuable. And seeing the positive impact on patient outcomes is perhaps the best incentive for others to step up and do the same.
To reap the benefits of blame-free incident reporting, safety must be deeply ingrained in the culture. Here are six ways you can bolster your safety culture – and in the process capture more incidents and near misses with more meaningful data:
Communicate success stories. Share stories where incident reporting made a real difference to a patient outcome – and be specific. Instead of simply saying that an incident report helped reverse a medication error, for instance, explain that the incident report was instrumental in stopping a child from leaving the hospital in time to reverse a dangerous medication error before any damage was done.
Close the loop. People like to know they had an impact on patient outcomes. When an incident report is received, promptly respond to the reporter with thanks. And once any investigation is complete, follow up with a second email explaining what actions were taken and the result.
Conduct daily stand-up meetings. Regular, informal meetings where the group can openly discuss what happened and brainstorm solutions can strengthen the bond among co-workers and foster a community of trust and unity.
Celebrate action. Even the most careful people sometimes make mistakes. But instead of focusing on what went wrong, commend the person for catching the mistake in time to prevent harm. Something as simple as changing the terminology from “near miss” to “good catch” can put a positive spin on what happened, which can have a dramatic impact on attitudes – and actions.
Be transparent. It’s one thing for an incident report to fix an isolated incident, but quite another when that data is combined with other reports to significantly improve patient outcomes across the board. Sharing that result can be incredibly empowering to everyone who contributed.
Make it easy to report a problem. Paper-based forms that are hard to find – and even harder to complete – drag down the incident reporting rate, no matter how well-intentioned the staff. Updated technology that offers on-the-go access to easy-to-complete forms shaves precious minutes off of the reporting process. Not only does this make it more likely a physician or nurse can squeeze in an incident report while juggling patient demands, but the information can be captured when details are still fresh.
Taking blame off the table puts the focus of incident reporting exactly where it should be – on improving the safety of patients. Is your culture ready to give up finger pointing and make incident reporting truly blame free?