Top 5 success factors for your healthcare incident management
Vice President, HxCentral
Healthcare Incident Management…. Oh yeah?… why me?
8 out of 10 times people roll their eyes as soon as I say Incident Management. Well, none of us like incidents to happen around us. Even so record them, maintain and follow through.
Truth be told, Healthcare incident recording and management is one of the key quality processes to ensure the smooth functioning of a hospital. I’ve known organizations who’ve strategically used incident management to deliver an incredible experience to their patients. Not to mention, the data points from this process are the key KPIs in the leading Healthcare quality accreditations, such as JCI, NABH etc. We’ve analyzed multiple cases on how healthcare incident management process is really working on the ground and we could see a huge potential to make it much more efficient and real.
Here are 5 key observations with our views on how it can be improved:
#1 Still using pen and paper or excel sheets:
The medical staff, most of it, is still using paper/excel sheets to capture incident/audit information. This is making the process very general and is limiting the incident intelligence to the person who is capturing or reviewing it. The details/investigation points to be captured would vary based on the type of incidents like Needle Stick Injury, Pressure Ulcer, Phlebitis, Medication error or Healthcare Associated Infection. This demands various forms/excel sheets to be handled by the staff. This complexity is driving people away from complying with the process and resulting in more errors.
#2 Manually driven process:
Most of the processes we’ve seen are still manual causing delays, reworks and making it even incomplete. The process to be followed and stakeholders involved would differ based on whether it was a Sentinel, Major, Minor or a near miss event. The biggest issue observed was that the entire bandwidth of the quality team goes into follow-ups and documentation rather driving on ground actions for continuous improvement.
Digitization of the entire Incident Recording and Management process leveraging an intelligent and flexible workflow system would be an ideal solution. The system should be able to drive the entire process across functions/departments to complete it within the timelines and quality.
#3 All incidents are not getting recorded:
One of the biggest challenge faced by the leadership and quality team is to ensure that all incidents are recorded. In one of the surveys conducted with the nursing staff revealed that on an average only 60% of incidents are getting reported. If the hospital is serious about the quality of patient care and wants to eliminate risk, it is important to record every incident and drive appropriate corrective and preventive actions. We could observe multiple reasons behind this issue, ranging from fear of consequences, lack of infrastructure, complexity, the effort required to solve, lack of awareness, discipline and the list goes on.
As the reasons for this issue are many, multiple solutions need to be tried. First, it should be a system driven process than a manual one. Then, we may have to look at the option for anonymous reporting, make the system simple and user-friendly, gather maximum data from the system itself to minimize data entry, checks, and validations with other processes like patient complaints/feedbacks etc., provide multiple channels to access the system, communication and enablement programs etc.
#4 Effectiveness of Actions Planned:
Once the incident is recorded, multiple actions will be planned as corrective and preventive actions (CAPA). In most of the cases, the actions are assigned to an owner, the target date is set and communicated to the person/department through email or memo. What happens after that? Unless the action owner or the quality teams put enormous efforts to track it and drive it, the actions just lie on the paper and lose its importance. The quality team may be successful in driving actions for some critical cases. But, the chances of missing actions are very high thereby increasing the risk for quality patient care and business.
There’s only one solution here – a system driven action tracker initiated by the incident process and drive till closure systematically. It also gives an opportunity to have a common action tracker system across the organization not only to handle actions derived from Incident but also from various audits, patient complaints or feedbacks, internal reviews etc. So, the leadership and quality team have a single dashboard to see all the pending actions and performance related.
#5 Accreditations are still painful and a nightmare:
Accreditation audits demand a huge amount of data. Many times, the data is scattered all over and is not linked properly for easy demonstration. Naturally, the quality team with other stakeholders end up spending days and nights to just set this right. It is equally important that the team on the ground is also completely aware of the quality processes and follows it thoroughly. It adds additional pressure to ensure operations team readiness along with data and documentation.
It is important to practice the quality process on the ground, without any compromise, to get the real benefit of incident management. But how do we make it happen? A technology solution which can drive training and enablement programs, based on the roles, not only for the existing team but also for the new employees would be a great help in systematically enabling the process. It’s a good practice to make the relevant SOPs and reference documents accessible from the operational system to significantly reduce the error rate.
When it comes to getting data & reports aligned to what accreditation process demands, we have seen a lot of it can be managed by doing the right type of groupings and classification of Incidents and aptness of the data modeling and capture. With a right analytics and reporting engine, the needed KPIs would become online and effortless.
What’s more to be done to make it further impactful? Here are another 5 thoughts on the same.
# 1: Ensure Quality System is integrated with Clinical Solutions, HRMS and Enterprise IT. This will ensure:
Seamless access to information
Access control and security
Avoids duplicate data and efforts
Capability to analyze the data across platforms
#2: We recommend digitizing not only incident recording, but also the audits, be it for Nursing Quality, Medical Quality or even for HAI Prevention Audits. It makes the Audit process simple and increases the compliance. Enable auto triggering of Incidents or actions in case there are any deviations observed.
#3: Leverage Analytics and Automation to identify the targets for audits based on various data points, history of treatments etc. Some of it can come from clinical solutions and some may be from the quality management system. It is also important to ensure the right coverage to have good samples for audit. E.g. minimum 2 patients from every team, avoiding duplicate audits.
#4: The success of digitization purely depends on how well and faster it is adopted by the team. Ease of use would play a major role too. In our view, if we embrace more digitization, including the process which touches the employees on the ground and creates positive impacts on their experience, it will make this journey much more easy and impactful. Some low hanging processes, such as employee requests to HR, Facility, Travel etc. can be the immediate targets.
#5: Making the system accessible through mobile will ensure that the team can access solution anytime and avoids delays in recording and updating. Also enabling emails for notifications, review, and approvals make it handy for managers and function heads.
Healthcare incident management is crucial for the patient safety. At the end of the day, diligently following the process or not is an ‘intent’ issue. World-class incident management solutions are available for hospitals to take advantage and make the process simpler and beneficial.
I look forward to hearing your thoughts and experiences with healthcare incident management.