Patient safety

Anybody can report, and not everybody can read

Every member of the workspace can raise a report. Reading somebody else's is limited to the people who investigate them, because a reporter who expects to be read by the ward they reported stops reporting.

Naming a patient is optional

Most of what a safety system needs to hear about reached nobody: the wrong drug drawn up and caught, the rail found down. A form that demands a patient teaches people not to fill it in.

Report what happened, not who to blame

A near miss is worth reporting on its own. Those are the ones that show where the next one is coming from.

An incident is not part of the chart

Record the clinical facts in the patient's chart as well, where the people caring for them will see them.

It cannot be closed while work is outstanding

An incident closed over the top of an open action is the failure this exists to prevent: the paperwork says it was dealt with and the ward says nothing changed. Cancel an action that is not going to happen, with a reason.

Nothing is scored

How far it got is what you chose. Nothing recomputes it, ranks incidents against each other, or decides a cause.

Report something

1. Select Report something.
2. Choose what kind of thing it was and how far it got. Each kind says what it covers; Other is fine when nothing fits.
3. Say when, and where if it helps: the ward, room or department. Where is optional, and Not stated is an answer.
4. Describe what happened in your own words.
5. Say what was done at the time, if anything.

Investigate one

1. Open the queue and select an incident.
2. Select Take it up.
3. Add each thing that will be done about it.

Close it

1. Mark each action done or cancel the ones that are not going to happen.
2. Write what was concluded, for somebody reading it in a year.
3. Select Close the incident.