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QUASR Feature: Pseudo-Anonymous Reporting

Abishek Goda

QUASR results from a decade-long experience working in the incident and risk management space across industries. Through that experience, we saw the specific difficulties that the healthcare industry suffered from using generic products altered to suit their needs. We didn’t want to be presumptuous either. So we spoke to many industry leaders across the region, of hospitals of different sizes, and across roles and functions. One common feedback we received early on was the need for “anonymous reporting”.

anonymous-reporting

Anonymous Reporting

As the name suggests, anonymous reporting is when an incident report is not attached to any particular user/staff in the system. Many hospitals felt the need for such a system to ensure more participation from all staff. While every hospital works very hard to provide a safe space for all its staff, fear is irrational. While the purpose of incident reporting and management is to improve organizational quality and safety, it isn’t easy to convince their staff that reporting an incident will not lead to repercussions.

Generally, anonymous reporting is employed only for whistle-blowing. And whistle-blowing is typically associated with grave issues in the organization. Incidents, on the other hand, whether grave or silly, are valuable sources of lessons and improvements for the organization. Secondly, coming from a computing background, we understand that genuinely anonymous is somewhat difficult to guarantee. It is usually possible to narrow it down to a small list of people! But not everyone realizes this. So we did not want to design a solution that would potentially blindside a staff. After all, the only guaranteed way to drive away any fear of repercussions is to build trust.

The other problem with anonymous reporting is: we cannot enable many user-friendly and time-saver features like multi-stage captures, draft retrievals, and the like. We are forcing the user to fill in a, typically, long incident form in a single sitting. Hospital staff are usually amongst the most time-crunched workers ever. Expecting them to block off time to report incidents will deter them from actually reporting any minor or near-miss incidents at all. For the organization, though, the near-miss or minor incidents are where the wealth of inputs are lost. Additionally, the quality managers and investigation teams do not have any starting point for conducting further assessments on the incidents — assuming they do not know who reported the incident.

Pseudo-Anonymous Reporting

At QUASR, we aren’t thrilled with anonymous reporting. We strongly feel that making incident reporting anonymous does not enable our customers with the right tools to improve their overall culture. After many discussions internally and externally, we arrived at what we call the “pseudo-anonymous” reporting or the “Protect” feature. This feature is available as standard and out of the box for all our enterprise customers. Lite does not support this feature. For Basic, we will wait to hear from you before enabling support for this feature.

To report an incident in the pseudo-anonymous mode, the staff user must first log in to the system. The reported incident is internally attached to the user. However, QUASR will hide this information from most stakeholders of the incident. QUASR will show the reported user as “PROTECTED” instead of their actual name. This way, the user’s identity is protected from the rest of the system. We believe this enables them to report without any fear of repercussions.

Like we mentioned, this mode is not an anonymous reporting mode. Typically, only Quality Managers will have access to the reporting person’s identity. Accessing the identity ensures that the quality teams can proceed to facilitate further investigations without much difficulty. Additionally, in places where a user trusts their supervisor, they can allow access to their supervisors. In most installations, only quality managers and optionally supervisors have access to the identity for protected incidents.

When users choose to report an incident with “protection” enabled, they have to read and understand their choice. There is an inline explanation of the behavior of the “protect” mode and allows the user to make a conscious choice. This additional step acts as a deterrent to using this mode unless necessary. We do not want the staff to abuse this option — even though it is not entirely anonymous, it does complicate the investigation process. It limits the options available to the quality management teams.

Advantages of Pseudo-Anonymous Reporting

The main advantages of pseudo-anonymous reporting or protected mode are as follows:

1. It allows users to report an incident without being anonymous and still protecting their identity from the larger group.

2. It enables quality management and investigation teams to perform meaningful analysis of the incident without revealing the reporting person’s identity. For anonymously reported incidents, it isn’t straightforward to get a significant investigation done from the report. Quality teams are left to make reasonable assumptions and proceed, which doesn’t lead to preferred outcomes.

3. It enables the organizations to set the right precedent in terms of their follow up actions to assure the staff that incident reporting does not lead to punitive measures.

Disadvantages of Pseudo-Anonymous Reporting

There are no silver bullets. And our solution is not without its limits. The main disadvantages of our approach are:

1. The staff must trust their quality managers to do the right thing. As we noted, this is not an easy task for the hospitals or the quality departments to achieve amongst all their staff.

2. Our solution targets Clinical incidents. However, many of our customers choose to track other incident categories as well. For a selection of HR-related issues, the pseudo-anonymous mode is not a good solution. It might worsen the situation for the staff.

3. Some incidents need to be whistle-blown for real change to occur. These are usually severe issues within the organization that pervade the entire structure. Pseudo-anonymous mode is not an answer to these types of problems.

We worry that enabling users with this mode gives them a false sense of security in the wrong situations! One of the purposes of this blog post is to educate our users on using this mode responsibly.

What can Healthcare Sector learn from Aviation Industry?

Abishek Goda

Ever since we spoke to Dr. Rosas, we have been wondering how healthcare safety can learn from the aviation industry – which, despite being nascent compared to healthcare, is reputed for its safety standards. We did much studying, and this article is a distillation of our thoughts. We have included all our references at the end of this article – as it turns out, we weren’t the first to ask this question!


Two seemingly different industries: What do they have in common, and where do the differences begin?


If one looks at it objectively, the conclusion one can draw is that although they are vastly different, they have many mutual lessons that can benefit each other. Over the last century, the aviation industry has seen massive growth, be it air traffic or the expansion of travel to different parts of the world. The sector has also secured a name for itself in terms of passenger comfort, safety, and, in most cases, timeliness. On the other hand, the healthcare industry has existed for more than a century and has seen many changes in treatment methods, care for patients’ wellbeing, and newer scientific discoveries for better health.


So, the question arises then: What can a sector created for transporting people and cargo by air have in common with the healthcare sector that deals with patients and treatment?


To give a fair picture, let us see some areas where we can compare the two, and the healthcare division can imbibe some lessons.

Safety

By and large, the aviation industry had the privilege of understanding what safety is regarding passenger and crew management. Use of Incident Reporting is one of the successful ways this is implemented. IR is a term familiar to many sectors and plays an essential role in preventing safety hazards or repeating errors. The aviation industry follows a standardized protocol for IR, which focuses on the larger picture and does not place all the accountability on the pilot alone.

Both pilots and doctors are professionals that hold the responsibility of safeguarding lives. Often errors have significant, irreversible consequences in either field. Yet, despite the high risks, the aviation industry leads IR with a blame-free atmosphere. A culture that is “open” and focused on learning allows the concerned parties to report incidents without the fear of adverse consequences. In the health industry, the report is often downplayed, leading to the repetition of an error. Healthcare requires an openness to modify policies without shifting the blame onto the staff or the members concerned.

One of the most successful ways the Aviation industry has ensured the safety protocols of its consumers is by adopting worldwide standards of secure transport. Many of us are familiar with the NTSB (National Transportation Safety Board). The NTSB takes on much responsibility when there is an accident. The incident is treated with grave seriousness, immediately catapulting a series of investigative reports regarding manufacturing, operation, and administration. This process guarantees that a quick decision is made and thus, lessens future debacles. When an incident occurs, the NTSB, given its integral influence on Aviation, is eligible to conduct a parallel investigation with the concerned Aviation system. The overall process has been largely effective in reducing fatality rates.

While the NTSB is a U.S-based organization, its standardization works across various countries. This two-layered work on incident reporting, where Aviation Boards work in solidarity with a larger system, has considerably played a critical role in increasing aviation safety.

Communication

In many sectors, employees downplay incidents for various reasons – one of the crucial reasons is the fear of losing employment. When an IR is created in the aviation industry, meetings discuss the incident, and there is no question of terminating employment. This openness to discussion discusses what had taken place and goes a step further in filling up gaps in communication. Aviation has a “Crew Resource Management” system, a system specifically designed for training on the job and facilitating professional communication. This system is where the airline crew, including the pilots and the flight attendants, and the ground crew and anyone involved with the airline communicates, and their cooperation dramatically reduces the risk of imminent danger.

Journaling is another vital aspect of airline staff that has helped the sector blossom. Pilots often write about their experiences of navigating a flight after landing. These journals are first-person accounts, maintained with details that may be both positive and negative, discussing the troubles faced during the flight and the overall journey. The crew are not penalized for sharing the mistakes in the journal. Every meeting is a step to betterment. Sharing the journal with the larger group of employees helps maintain transparency and leads to prevention. 

Understanding that passenger safety is of paramount importance and conceding that risk affects both the passengers and the crew, the open and learning culture of the aviation industry has come a long way in terms of care

Standardization

Indeed, the industries are different in terms of their period of existence, aim, and intricacies of customized caregiving. However, one significant learning that the aviation sector can provide is in terms of standardization. 

For airlines, the procedures are standard. From equipment, training, the language used to the IRS; the essentials are all well-structured and easy to follow for those involved. Most procedures in the aviation industry do not need second-guessing since all the information is readily available, including external factors such as imminent weather conditions, thereby reducing the risk of an unexpected catastrophe.

However, despite the differences that the healthcare sector faces from patient to patient, implementing standardized procedures for IRS or training the staff would greatly add value and be a step towards betterment

Responsibility

The final section is an overview of the workforce involved in either industry. When issues occur, an investigation is often conducted nationwide or even internationally for the aviation sector. However, many of the incidents in hospitals are only locally addressed and do not receive widespread attention unless for exceptional reasons. Doctors and staff are often at the receiving end of criticism, and the effects are long-lasting. Even minor incidents in aviation garner media attention. This attention contributes to an efficient working atmosphere in the aviation sector. Governing bodies created to address issues and almost infallible checklists to verify the smooth functioning of an airline, both on the ground and in the air, has primarily created a positive customer experience.

Aviation ensures an atmosphere of zero anxiety both for the staff and the passenger while placing enormous importance on comfort and safety. While healthcare organizations and national health governance bodies carry out significant reforms frequently, the lack of a centralized body responsible for investigation and policy formation leaves the individual organizations on their own regarding patient safety

To Conclude

There are many reasons why we cannot compare the healthcare industry to the aviation sector. The above are some aspects the two industries are similar. Over the years, the healthcare sector has seen much positive change, and these suggestions can only steadily contribute to a healthier future, mindful of safety and transparency.

References

Beentjes, Bianca (August 20, 2020). “What can the aviation sector teach the healthcare sector about safety?” Accessible here.

 

Dhand, Suneel (April 7, 2016). “Here’s Why You Can’t Compare Healthcare to the Airline Industry.” Accessible here.

 

Hunter, Greg. (September 27, 2017). “Healthcare Can Learn From the Aviation Industry About Safety” Accessible here.

 

Kapur, N., Parand, A., Soukup, T., Reader, T., & Sevdalis, N. (2015). Aviation and healthcare: a comparative review with implications for patient safety. JRSM Open, 7(1), 2054270415616548. Accessible here.

 

Meiners, John (June 13, 2019). “What can healthcare learn from the airline industry?” Accessible here.

 

Parmar, Hemraj (September 19, 2014). “Lessons for the Healthcare Industry from the Aviation Sector.” Accessible here.

 

Rice, Stephen ( February 7, 2020). “What Can Healthcare Learn From Aviation Safety?” Accessible here.

 

Swartz, Martha K. Swartz (2015). “What Health Care is Learning From the Aviation Industry”. Journal of Paediatric Health Care, Vol 29 Number 1. Accessible here.

 

Digitization – A Pathway Towards Digital Transformation

Rohini
Digitization-vs.-Digitalization-Banner

If we look back two and half decades, businesses have to provide input to their computing devices to convert data into a digital format.

Leaping for a few years, businesses gain capabilities to process data over digital technologies instead of the manual or offline system.

This digital evolution is called digitization to digitalization!

Confused?

Like their spellings—digitization and digitalization are insanely interlocked together that anyone can get confused between both terminologies. However, if we try to explain in one line

—‘digitization is information’ and ‘digitalization is a process.’

We know it still doesn’t give away why digitization and digitalization are different when they both deal with processing and interpreting information?

So, let’s dig deeper and understand what lies in the roots of digitization and digitalization.

What is Digitization?

According to Oxford's Dictionary — “Digitization is the process of changing data into a digital form that can be easily read and processed by a computer.”

In layman’s terminology, digitization is a method to turn information into binary digits (1’s and 0’s) so that computers can easily understand and process it.

In this process, the user takes analog information such as photographs, soundtracks, or documents and converts them into a digital form that can be stored and accessed by digital devices.


For example
, a hospital converting patients’ paper records into Excel sheets for better preservation and access. Additional examples—scanning old documents to PDFs, transforming printed reports to meaningful data, turning a vinyl record into an MP3 file, and so on.

 

Whether you wish to preserve old information or capture new information for later use, the information dealing process will be called digitization

Why is Digitization Important for Your Business?

According to a McKinsey report, the pharmaceutical and medical industry shows the least amount of digital frontier gap for 13.4% and travel sector maximum for 51%. In this, if you are still wondering why to take a step towards digitization, reasons are:

Market Trends:


It doesn’t matter which industry you are part of—the digital wave is everywhere. Thanks to cheap internet services and smart gadgets, today, digital technologies are in everyone’s hands. From booking a cab to consulting a doctor, everything is digital—now, it’s up to you whether you want to be part of the trend or not?

Improve Efficiency:


Your paperback business documents are prone to theft, loss, wear and tear—with no way to replace them. Therefore, if you don’t want to reduce your business efficiency due to inefficient information, safely store your data in a digital format.

Better User Experience:


Presently, a fast and smooth user experience is an imperative way to grow your business, which you can’t achieve via manual services. The progressive businesses have completely understood this phenomenon, such as Pizza Hut started taking their customers’ orders through the interactive touch screen in their restaurants.

Limited Growth:


If you haven’t digitized your data yet, you cannot take leverage from the new growth and marketing metrics such as social media.

What is Digitalization?

If you search for digitalization definition on Oxford’s dictionary, you will receive the same definition as digitization.


Wait, what?

Then, how come both terms are different?

Well, they are different—trust us, just let us break the concept for better understanding. Earlier, we mentioned that when a hospital converts patients’ records into Excel sheets, it’s digitization—but, when a hospital receives patients’ records in email and adds them into Excel sheets, records are already digitized; thus, this concept will be called digitalization.

So, digitalization is a process of converting information into different digital equivalents. For instance, recording a patient’s data using a digital registration method is digitalization, but scanning printed records into digital form is digitization.

Digitalization is an ongoing process as new technologies are emerging and expanding the further scope of digital development. Therefore, twenty-first-century businesses can’t avoid digitalization!

Why Is Digitalization Important for Your Business?

Roughly 4.66 billion people around the globe are using the internet at the beginning of 2021—that means 60% of the world’s population has embraced digitalization. However, if you haven’t digitalized your business yet, you should because:

Collaborated Team: When marketing and technical teams collaborate together, they can better understand customers’ needs and find better solutions to satisfy them. Using the analytical tool, the marketing team can effectively analyze market trends and provide correct data to the sales team to quickly convert potential leads into customers.

Improved Data Collection: Nowadays, businesses are busy collecting mountains of data related to their customers, but the real benefit is optimizing collected data for analysis. With digitalization, a system can gather the right data and intelligently analyze it.

Resource Allocation: Digitalization can consolidate business resources into a centralized software for easy access. In 2020, businesses used an average of 900+ applications to run their operations, which makes it very hard to derive information from the various portal. Digitalization can help in streamlining different data silos to provide efficiency across units.

Elevated Profits: Digitization pushes businesses towards better efficiency and profitability. According to the SAP Center for Business Insights and Oxford Economics report, —80% of fully digitalized companies have recorded upward growth in their profits. Now, this fact is sufficient to know to prove how digitalization can improve business profits.

Key Differences Between Digitization and Digitalization

For better clarification on the notion—‘digitization is information’ and ‘digitalization is process’—let’s understand what primarily set both terms apart.

Information Conversion

In both terms, information is converted from one form to another. Where digitization is converting analog information into a digital form, on the contrary, digitalization transfers information to equivalent digital devices. The information might be a common factor here, but the way to deal with it is completely different

Basic Purpose

Digitization is performed to make information highly accessible to a company. Imagine, when a hospital wants to retrieve the gynecologist department’s records for 2012, the manual search might take lots of time—even if all the documents are chronologically arranged. On the other hand, digitized records can be retrieved with one click, which makes it easy to access information.

 

The purpose of digitalization is beyond accessing information; it is a process of analyzing and interpreting information to improve productivity and efficiency. Such as, once the hospital has received information, they can analyze the gynecologist department’s data and interpret comparisons between 2012 and 2021 performance rates.

Functionality

Both terms are polar apart on the functionality grounds—digitization operates to store information permanently, and digitalization focuses on improving data accuracy.

For instance, a healthcare clinic can create permanent data backup digitally so that natural calamities, theft, or other incidents won’t damage their vital information. Next, they can form a correlation between information and arrange systematically to provide solutions. In a way, digitization stores information, and digitalization process that information.

Nature of Data

Digitization is performed to make information highly accessible to a company. Imagine, when a hospital wants to retrieve the gynecologist department’s records for 2012, the manual search might take lots of time—even if all the documents are chronologically arranged. On the other hand, digitized records can be retrieved with one click, which makes it easy to access information.

 

The purpose of digitalization is beyond accessing information; it is a process of analyzing and interpreting information to improve productivity and efficiency. Such as, once the hospital has received information, they can analyze the gynecologist department’s data and interpret comparisons between 2012 and 2021 performance rates.

Tools

Digitization and digitalization aren’t possible without adequate tools. For digitization, input tools are mainly used like Scanner, Digital Camera, Storage & Retrieval Systems, OCR Software, and others.

Multiple software solutions are used to accomplish the digitalization process, such as ERP Software, Messaging & Conferencing Software, Predictive Maintenance Systems, Robotics & Controller Systems,, and more.

Example

Suppose a doctor is conducting a study on traditional chronic diseases. For research purposes, he collected multiple handwritten paper manuscripts of his old patients and converted them into a checklist app to easily access the relevant information for his research.

Next, he used digital technologies to process and analyze data in real-time and draw insightful conclusions to include in his study.

Future of Digitization & Digitalization — Digital Transformation

Digitization was started around 25 years back when computer systems became part of mainstream activities—so we can say that it’s now completed.

After digitization, the digitalization process began and continued to evolve with the introduction of new technologies. Slowly, digitalization is moving towards the digital formation—the future.

Digital transformation is a high-level digital business perspective where strategic decisions are made to take leverage from all digital technologies and change the overall approach of the business to create a resilient environment.

It is a broad framework, which is still evolving with the help of new technologies. It is projected that the global digital transformation market size will expand at a CAGR of 22.5% between 2020 to 2027

Wrap Up


On parting thoughts, digitization deals with information, digitalization manages processes, and digital transformation happens to be a reformation. If we say digitization was the past and digitalization is the present, digital transformation is definitely the future.

 

So, it is step after step, which businesses should embrace to stay ahead of the competition and prepare themselves for the future.

Digitize, Digitalize and Digital Transformation

Rohini
digitize-vs-digitalize

Yes, you read that right. There is a small but appreciable difference between digitize, digitalize and digital transformation. We’ll try to articulate this as we go

What is Digitization?

A vast majority of small to medium healthcare providers in the region track their safety and quality metrics manually. ‘Manually’ is sometimes as basic as a paper record, sometimes is an excel sheet and some other times it’s a Google form. We categorize all of these as manual. The effort required by a single person to track and maintain this data is significant. Moving from a paper record to a digital record is simply digitization. That is, you made the record accessible as data. But digitization, by itself, doesn’t solve the problem of manual effort involved. It still is an excellent first step to take.

What is Digitalization?

On the other hand, digitalization is to enable an organizational process on top of digitized data. It involves a slight rethinking of how to transform the process to suit an online world.

Digitalization is the use of digital technologies to change a business model and provide new revenue and value-producing opportunities,”
according to Gartner’s glossary.

Digitalization will be a crucial tool in enabling better decision-making and better improvement programs across the organization. This usually federates the data collection across stakeholders with each performing their portion of the workflow. Alongside collecting valuable and insightful data, digitalization can reduce a lot of time for anyone involved in the quality and safety workflow

What is Digital Transformation?

Digital transformation is beyond Digitalization. Digital transformation is not entirely only technology. Although IT will play an important role in driving digital transformation strategy, the work of implementing and adapting to the massive changes that go along with digital transformation falls to everyone. 

Digital transformation is
essentially about the customer and how you fundamentally change your way of operations and deliver value to customers.  It is a cultural change that requires organizations to continually challenge the status quo.

There is no magic formula for the digital transformation project to be successful, as all digitalization projects need to be customized to your specific situation.

Our QUASR imbibes both digitization and digitalization incident reporting system that offers comprehensive features for patient safety industry.