Improving critical incident reporting in primary care through education and involvement

  • Background: Critical incident reporting systems (CIRS) can be an important tool for the identification of organisational safety needs and thus to improve patient safety. In German primary care, CIRS use is obligatory but remains rare. Studies on CIRS implementation in primary care are lacking, but those from secondary care recommend involving management personnel. Objective: This project aimed to increase CIRS use in 69 practices belonging to a local practice network. Methods: The intervention consisted of the provision of a web-based CIRS, accompanying measures to train practice teams in error management and CIRS, and the involvement of the network’s management. Three measurements were used: (1) number of incident reports and user access rates to the web-based CIRS were recorded, (2) staff were given a questionnaire addressing incident reporting, error management and safety climate and (3) qualitative reflection conferences were held with network management. Results: Over 20 months, 17 critical incidents were reported to the web-based CIRS. The number of staff intending to report the next incident online decreased from 42% to 20% of participants. In contrast, the number of practices using an offline CIRS (eg, incident book) increased from 23% to 49% of practices. Practices also began proactively approaching network management for help with incidents. After project completion, participants scored higher in the patient safety climate factor ‘perception of causes of errors’. For many practices, the project provided the first contact with structured error management. Conclusion: Specific measures to improve the use of CIRS in primary care should focus on network management and practice owners. Practices need basic training on safety culture and error management. Continuing, practices should implement an offline CIRS, before they can profit from the exchange of reports via web-based CIRS. It is crucial that practices receive feedback on incidents, and trained network management personnel can provide such support.

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Author:Beate MüllerORCiDGND, Martin Beyer, Tatjana Blazejewski, Dania Gruber, Hardy Müller, Ferdinand M. GerlachORCiDGND
URN:urn:nbn:de:hebis:30:3-516444
DOI:https://doi.org/10.1136/bmjoq-2018-000556
ISSN:2399-6641
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/31523734
Parent Title (English):BMJ open quality
Publisher:BMJ Publishing Group
Place of publication:London
Document Type:Article
Language:English
Year of Completion:2019
Date of first Publication:2019/08/19
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/01/08
Tag:medical error; patient safety; primary health care; risk management
Volume:8
Issue:3, e000556
Page Number:5
First Page:1
Last Page:5
Note:
Copyright information
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
HeBIS-PPN:459379097
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Open-Access-Publikationsfonds:Medizin
Licence (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 4.0