Systems to support improvements


Return to Safety and Quality		Introduction to Safety and Quality Principles > Systems to support improvements

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Incident reporting

What is an incident?

A healthcare incident is an event …. which could have, or did, lead to unintended and/or unnecessary harm to a person, and /or a complaint, loss or damage.
Australian Council Safety and Quality in Health Care

What needs to be done to encourage people to report incidents?

A reporting culture is needed
People must feel free from fear of blame if they are to report errors
“Every effort should be made to create …an open …environment in which it is safe to report”
NPSA Seven steps to patient safety

How can the information from incident reports be used?

Provides information about the type of incidents that are occurring
Helps identify where safer systems are needed
Provides information about the effect of system changes

What is a ‘Near miss’?

An incident which did not cause harm but could have

Should be treated as an incident and an incident report completed
‘Free go’
- System change can be made without any harm having occurred
Should be treated as important learning opportunities

Often near misses are not reported because no harm occurred

May be seen as creating more paperwork
Need to be seen as an important part of improving patient safety

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Contents | Page 16 of 26

Last updated: 14 August, 2009
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