Incident reporting provides two types of data: epidemiological data about the entire patient population, and specific data on the treatment of a subgroup of the patient population. The processing of incident reports must reflect both of these data needs. Long-term trend analysis and rate data must be developed by classic statistical means. These data can be coded at leisure, and the data can be analyzed at periodic intervals. Patient-specific data must be processed in a much shorter time frame. If quality control techniques are to be applied to individual patient injuries, the quality control manager must be notified of the injuries at once. This necessitates a preliminary screen of the incident reports before they are entered into the data review pipeline. It also requires that the incident reports be filled out promptly. This quick-reporting requirement limits the amount of paperwork that can be tolerated in filing an incident report.
A single-sheet, multiple-copy form is the best approach to incident reporting. The form should contain basic patient identification data, a checklist of different incidents, and a space for written comments. The person filling out the form should include factual information but should not draw any conclusions. The nursing supervisor should review all reports after they are filed but should not be able to prevent a report from being reviewed by the quality control manager. This review enables the supervisor to supply additional information, if needed, and to identify reports that require immediate action.
There should also be a mechanism for directly alerting the administrator if the nurse or other person filling out the form feels that the incident demands immediate attention. The mechanism for direct reporting can be very valuable when the appropriate supervisor is unavailable. The hospital must be careful to balance its need for well-established chains of command with its need for prompt intervention in manageable incidents. The administrator must not be cut off from vital information if a person in the usual chain of command is absent. This is very important for individual incidents and for trend analysis of incident patterns.
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