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Participation Matters!

Abishek Goda

Active participation is an essential ingredient of all successful systems. Incident or Risk management is no exception to this. In this article, we understand why active staff participation is critical to all successful implementations. We will also explore a few ideas on how you can leverage this in your systems as well. Lastly, we add a note on how QUASR achieves this for you in the Incident Management space.

Participation-Matters

Participation

Active participation, we define, is the level of engagement users have with a system. In an incident management system, this can be the familiarity and comfort that users have to report an incident or an issue using the system. In common parlance, there are metrics like daily active users (DAU) or monthly active users (MAU) used to define how successful a software system is. However, in Incident or Risk management systems, these metrics are not very useful indicators. We measure participation as the willingness to interact with the application for these cases.


Interestingly, the only way to unlock the full potential of an incident or risk management system is by optimizing for high DAU. We need all the staff to play their role in ensuring incidents are handled with sufficient detail to ensure they don’t occur again. Except, this is not something that the software provider can manage. The organization needs to facilitate and encourage this as part of its culture.

Factors Affecting Participation

A common problem with most enterprise systems is the user attitude to the system. Multiple factors influence the user perception of the system: organizational stand on the system; hierarchy and their position within that; whether the system feels intimidating; and how welcome they feel when they do participate in the process. For an incident management system, however, a lack of active participation results in poor outcomes. If the system does not capture as many incidents as possible, the organization cannot improve its safety process. Or if the incidents reported are not analyzed, investigated, and brought to a closure in a timely fashion – again, the organization cannot improve its safety process. In both these cases, the problem might be that users are not playing the role required to ensure the overall success of the process.

Secondly, incidents are not the domain of any particular staff of a hospital. For instance, caregiving is exclusive to doctors or nursing staff, just as dispensing is exclusive to pharmacy staff. But when an incident occurs, everyone from the nursing staff, pharmacy staff to janitorial staff, and service providers that are peripheral to the organization have an essential role to play — report the incident and help in whatever way they can to ensure a smooth closure and learning from the incident. 

Investigation of an incident or its root cause analysis is a group activity. In many cases, each hospital has its designated and identified experts at running this activity. Despite their expertise, the investigation staff cannot conduct a productive root cause analysis if the staff who understand the incident or the process do not come forward with their viewpoints and suggestions. Often, though, staff might quickly feel intimidated to participate amidst experts and refrain from voicing their opinions. Users on the ground may have a slightly different perspective of the issue and have important insights. Their lack of participation denies the organization a chance at improving the process!

Similarly, staff should not feel like they are “on the hook” for their participation. The environment to encourage participation is very forgiving and open in nature. The management usually needs to step up, ensure a safe space for all their staff, and encourage them to do the right thing. From the perspective of patient and worker safety, the only way forward is inclusive of all stakeholders.

Lastly, an overlooked reason for the lack of participation is that the user interface is very complicated and intimidating to use. When the quality or risk management teams implement a digital solution to their process, they are often focused on the process and forget the importance of keeping things simple. As the understanding goes, it is pretty complicated to design a simple system and is quite simple to design a complicated one. When designing a system, we often optimize for the results and impacts but fail to account for ease of use; users need to participate actively to achieve the results.

How Does QUASR Achieve This For You?

A core tenet in the design of QUASR is user participation. QUASR builds on the best practices commonly used elsewhere in the software industry. Our user interface and usability are very similar to hugely popular apps like Facebook or Gmail. Similarity with other popular applications helps us leverage the familiarity that the users already have. 

Secondly,  QUASR brings multiple simple but niche features like save draft, multi-stage forms, flags, and widgets to simplify how a user sets to achieve their tasks in the incident. Further, we have features like pseudo-anonymity to encourage participation without fear of repercussions. The list is exhaustive, and covering them all would become a blog post on its own. Feel free to talk to us to understand how you can benefit from using QUASR in your organization.

QUASR Feature: Sensitive Incidents

Abishek Goda
QUASR-Feature-SensitiveIncidents-Header

One of the core tenets of QUASR is transparency and knowledge sharing. In some sense, these two go hand in hand in most cases. Knowledge sharing happens when there is transparency within the community or organization. Incident Management is an essential first step to many organizational improvements. Pro-active Risk Management uses Incident Management as one of its drivers, for instance. Awareness of the incidents that occur in the hospital helps the management plan their mitigation and ensure they do not affect their facility’s overall quality and safety. Similarly, tracking and investigating incidents usually gives valuable inputs to quality and safety policy that every institution’s staff is aware of intimately.

Incidents, sometimes, have information that cannot be widely disseminated or discussed across all staff. We can identify many reasons why this is the case: maybe the people involved are highly placed individuals in the society; perhaps the event has a far-reaching impact if mishandled, or maybe there are legal reasons to restrict the audience. General dissemination of such information can lead to gossip or widespread speculation. In the era of viral social media, the organization may be dealing with a PR nightmare while managing the actual issue or incident. Besides, such speculation can also cause unintentional and unfounded concerns to staff or patients.


It is, then, only natural that Senior management and Quality Managers will want to restrict the audience of specific incidents to a select staff only.  

Sensitive Incidents are the digital equivalent of a “Private & Confidential” document of the paper-office era.

Sensitive Incidents in QUASR

We, at QUASR, recognize this problem very well. While we want to build a transparent, knowledge-sharing platform, we also want to enable our customers to restrict information to a restricted group of staff as the need arises. This feature is a standard feature built into QUASR and is available for all BASIC and Enterprise plan customers.

The LITE plan does not include this feature since the plan only targets a closed group of users within the larger institution. If enough customers feel LITE should have this feature, we will enable it for that plan.

Sensitive Incidents in BASIC

In BASIC, any user with sufficient privileges can mark an incident as Sensitive. Sensitive incidents in the BASIC plan have a fixed behaviour for all our customers. Only users with the privilege to view such incidents are allowed to view all parts of the incident. Other users can only access the basic incident information and supervisor review information. Similarly, access to widgets is also limited to users with access to sensitive incidents. Only users with sensitive incident access can attach files, invite other participants, and add new notes to such incidents.

Sensitive Incidents in Premium

The premium plan has two significant differences from the BASIC plan. In the premium plan, the sensitive feature is in quality manager access. By default, the quality manager is the only role that can mark an incident as sensitive. The Quality Manager role is the primary stakeholder in the premium plan for incident management, hence this decision. However, it is possible to configure and extend this to other roles at the time of implementation.

Secondly, we implement the sensitive feature as a “flag” in the system. Doing so allows us to extend all the additional benefits of the flag to the sensitive flag. Flagging an incident adds a visual cue to the incident view to indicate the flag. It also notifies a predefined set of stakeholders about the occurrence of a sensitive incident. Additionally, these predefined stakeholders automatically gain access to the incident — even if they are not initially involved in the incident. We will dedicate another post in the future to discuss the flag system in QUASR.

Premium and BASIC versions treat the access to the incident information similarly. Whereas the role and its permissions determine the behavior in BASIC, Premium restricts access to Quality Managers, Administrators, and Management roles. Again, in Premium, it is possible to configure this behavior to the organization’s specific needs

Striking A Balance

In QUASR, by implementing this feature, we forgo transparency and open communication. However, we believe we have struck a middle ground between restricting access and openness. The primary incident information remains accessible to all staff at all times. Only the more advanced information like Quality Review or Investigation and RCA details are unavailable to all users. We believe this still allows all stakeholders to stay updated on all their concerning incidents in the organization.

How does your organization handle sensitive incidents? Whether you use a manual or a paper-based system or a digital system to manage your incidents, please let us know your thoughts and suggestions on this feature.

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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.

 

Incident Reporting in Healthcare: A Complete Guide (2021)

Abishek Goda

Hypothetically, if you ask someone where you are likely to meet with an accident — in a hospital or while driving a car — most people will say hospitals are the most unlikely place to get injured.
  

Unfortunately, the actual medical situation is a bit different compared to a hypothetical situation. According to a 2015 study by the UK National Health Services (NHS), it is believed that 10% of critical accidents occur in all hospitals. 


Even the World Health Organization (WHO) has estimated that 20-40% of global healthcare spending goes waste due to poor quality of care. This poor healthcare quality leads to the death of more than
138 million patients every year.

Patient safety in hospitals is in danger due to human errors and unsafe procedures. Everyone makes mistakes, even good doctors and nurses. However, by recording those errors, analyzing and following up, we can avoid the future occurrence of errors/accidents.


To err is human, they say. The best thing we can do as humans is to learn from these mistakes and avoid repeating them in the future. When we adopt this feedback approach in hospitals and other healthcare spaces, we can improve patient safety in healthcare.


Knowing why, when, and how to report an incident can help improve patients, hospital staff, and organizations’ safety. This guide will walk you through all the different aspects of incident reporting in healthcare. It will show how to file an accurate incident report to establish high healthcare standards worldwide.

What Does Incident Reporting in the Healthcare System Means?

To err is human, to cover up is unforgivable, and to fail to learn is inexcusable."

Prof Liam Donaldson (WHO Envoy for Patient Safety)

An incident is an unexpected event that affects patient or staff safety. The typical healthcare incidents are related to physical injuries, medical errors, equipment failure, administration, patient care, or others. In short, anything that endangers a patient’s or staff’s safety is called an incident in the medical system.

The process of collecting incident data and presenting it properly to action is known as ‘Incident Reporting in Healthcare.’ With incident reporting, an emerging problem is highlighted in a non-blaming way to root out the cause of the error or the contributing factors.

Designated staff with authority to file a report, or staff who has witnessed an incident firsthand, usually file the incident report. Usually, nurses or other hospital staff file the report within 24 to 48 hours after the incident occurred. The outcomes improve by recording incidents while the memories of the event are still fresh.

When To Write Incident Reports in Hospitals?

When an event results in an injury to a person or damage to property, incident reporting becomes a must. Unfortunately, for every medical error, almost 100 errors remain unreported. There are many reasons for unreported medical incidents, but not knowing when to report is one of the most common ones. 


Unfortunately, many patients and hospital employees do not have a clear idea about which incidents to report. Knowing when to report in hospitals can boost safety standards to a great extent.

Let’s consider these situations:

✅ A nurse is helping a patient walk from his bed to the bathroom. However, he stubs the big toe on his left foot on the IV pole that he is dragging.

✅While injected the accident patient’s IV with pain medication, the nurse misread the label and administered a heavy dosage than prescribed, which increased the patient’s blood pressure level. 


In these situations, it is necessary to fill in the incident reports. Simply because an unexpected event occurred and lead to harm, it doesn’t matter how severe or minor the incident is. It is essential to report all incidents.

 

Purpose of Incident Reports

Incident reports provide valuable information to hospital administration facilities. They capture data required to highlight necessary measures to improve the overall safety and quality of the hospital. An accurate incident report serves multiple purposes.

1. Root Cause Identification

All incidents have a cause. Mishaps are pretty uncommon in hospital settings, and most incidents can be root caused by a potential reason. Correcting the root causes can easily avoid future incidents of that type. In this sense, root cause analysis of an incident is an essential investigation step for all hospitals to ensure their staff and patients are safe under most conditions.

2. Policy and Process Improvements

 

Some incidents are part of a larger pattern that can only be identified by looking at them together – let’s say, for example, through a Swiss cheese analysis model. Such assessments usually identify more significant issues that aren’t immediately apparent from individual incident reports or investigations. These assessments feed into clinical risk management as well as help guide the hospital administrators to tweak their policy or process guidelines to help staff adhere to a safer care routine. 

 

For example, let’s take a pattern of incidents. Each has a root cause individually to what looks like a handover issue – but at different stages or different type of facilities. It would be possible to tweak each of these handover processes individually to fix that specific issue. However, it may be more productive to improve the overall handover process by taking all the incidents as a whole and tweak to address them together.

3. Clinical Risk Management

 

All hospitals have and use their enterprise risk management processes. Clinical risk management, a subset of healthcare risk management, uses incident reports as essential data points. Risk management aims to ensure the hospital administrators know their institution’s performance and identify addressable issues that increase their exposure. And the ability to assess clinical risks ensures the hospitals can stay ahead in their business and provide high-quality care and a safe workplace for all staff.

 

4. Continuous Quality Improvement (CQI)

 

All hospitals have continuous improvement plans that help them stay updated with all the latest developments in patient safety and quality by assessing, evaluating, and improving their processes and methods over time. Having incident reports duly filled and followed up to closure helps the CQI process to identify potential areas of improvement and help the organization achieve a more successful CQI cycle that takes them forward.

 

5. Better Training and Continuous Learning

 

Incident data are essential sources of knowledge and on-the-job training material. Incident investigation is a rich source of information that will help new staff understand why the hospital has a specific process that may differ from their previous workplaces. Similarly, having a robust incident management system helps implement a good continuous learning program for the staff that helps them learn the most important details they need to be efficient in their day-to-day work.

 

Different Types of Incident Reporting in Healthcare

An incident is an unfavorable event in health organizations. But, the nature of the incident can vary based on numerous circumstantial factors. Broadly, there are three types of incident reports:

1. Clinical Incidents

A clinical incident is an unpleasant and unplanned event that causes or can cause physical harm to a patient. These incidents are harmful in nature; they can severely harm a person or damage the property.

For example—

● Nurse administered the wrong medication to the patient. 

● Unintended retention of a foreign object in a patient after a surgery. 
● Blood transfusion reaction.

2. Near Miss Incidents

Sometimes an error/unsafe condition is caught before it reaches the patient. Such incidents are called “near-miss” incidents. However, the problem might have diffused before the severe harm, but it is still essential to report near-miss incidents. Nearly 50 near-miss incidents occur for each injury reported.

 

For example—

● A nurse notices the bedrail is not up when the patient is asleep and fixes it. 

● A checklist call caught an incorrect medicine dispensation before administration. 
● A patient attempts to leave the facility before discharge, but the security guard stopped him and brought him back to the ward.

 

3. Non Clinical Incidents

Non-clinical incidents include events, incidents, and near-misses related to a failure or breach of EH&S, regardless of who is injured or involved.

For example—

● Misplaced documentation or documents were interchanged between patient files. 

● A security mishap at a facility.

4. Workplace Incidents

A work accident, occupational incident, or accident at work is a discrete occurrence that can lead to physical or mental occupational injury. The workplace incidents are related to mental as well as physical hurts. According to the BLS’s Workplace Injuries and Illness News, nursing assistant jobs have the highest incidence rates.

 

For example—

● Patient or next-of-kin abuses a care provider – verbally or physically – leading to unsafe work conditions. 

● A healthcare provider suffered a needle prick while disposing of a used needle.

 

Who Prepares Incident Reports in Healthcare Facilities?

At QUASR, we believe all staff (and patients, too) should be able to report incidents or potential incidents they have witnessed. But in practice, it is a bit different. Some hospitals have designated persons who are authorized to file the reports. In some other hospitals, the staff usually updates their supervisor about an incident, then can file the report. 

QUASR clients, usually, have configured to give access to all their staff so that they can initiate an incident report enabling them to stay aware of all the issues that occur – however minor or inappropriate it may be. Allowing all staff to report requires a training effort from the quality and safety teams to ensure all the employees understand what and when to file an incident report

incident-reporting

Critical Components of Incident Report

One comprehensive incident report should answer all the basic questions — who, what, where, when, and how. Most hospitals follow a preset reporting format based on their organizational needs. However, an incident report must cover the following aspects:

1. General Information

The well-informed incident report needs basic information such as the date and time of the incident. Additionally, for future analysis, your report must include general information.

2. Location of the Incident

Specifically, mention the location of the incident and the particular area within the property—for example, patient X fell in Ward no. 2 near the washroom. With the location specifications, administration staff can better investigate the reason behind the incident and fix it.

3. Concise yet Detailed Incident Description

The incident description needs to be clear and meaningful — don’t use vague language, never add baseless information, and keep personal biases out. Whenever you have to add your opinion to the report, mark it as an assumption or subjective opinion.

4. Type of the Incident

You should define the nature of the incident while reporting to get a clear view. We can categorize the hospital incidents into different sections such as Medication Error, Patient Fall, Equipment Damage, Abuse, Pressure Ulcer, Radiation, Surgery/Anesthesia, Laboratory related, Security, Harassment, Loss or damage to property, Patient Identification, among others. QUASR offers 25 such incident types built-in by default.

5. Information of all Parties Involved in the Incident

The administration needs the name and contact details of all the parties involved in the incident. The report should capture all the relevant information required to follow up with the involved parties.

6. Witness Testimonies

If there are witnesses available to the incident, it will be helpful to add their statements in your report. While writing witness statements, focus on the following attributes — specific details provided related to the incident, use quotation marks to frame their accounts, note witnesses’ location at the time of the incident, and how they are related to the incident.

7. Level of Injury

In case of injury, the reporting staff must record the injury level and cause in the report. If the incident involves an in-patient at the hospital, their medical records will reflect the treatment and diagnosis of the injury. However, for others, it might be required to follow up and record their injury diagnoses.

8. Follow Up

The incident report is incomplete without the follow-up action details. Each report should include remarks stating what preventive measurements and tactics you have opted to avoid such incidents in the future.

9. Reviews

Once a final follow-up on the incident report is made, the next phase is reviewing. In this step, the supervisor or manager ensures the implementation of corrective actions against the report. The goal of the review is to prevent the recurrence of the incident and create immediate action plans. While reviewing incident reports, a reviewer should consider the following things:

10. SBAR

SBAR abbreviates Situation, Background, Assessment, and Recommendations. The reporting person’s supervisor at the time of the incident typically performs SBAR. SBAR attempts to capture more structured information about the incident, what happened, pre-conditions leading to the incident, information about the patient or staff, if involved, a first assessment of what caused the incident, and recommendations for follow-up or corrective actions.

11. Risk Scoring

A risk score is a calculated number that reflects the severity of risk due to some factors. We compute risk scores as a factor of probability and impact. It is common in the industry to use a 5×5 risk scoring matrix. But there are other methods too, and sometimes the scoring changes based on the type and nature of the incident.

12. Investigation Information

An investigator or an investigation team needs to go through all the supporting evidence to analyze the incident. The incident supporting comes in different forms, such as photos, CCTV footage, and witness statements. It is essential to verify the supporting evidence during an investigation. Information investigation often leads to:

13. Root Cause Analysis

Root cause analysis is a problem-solving method used to identify the root cause of the problem. The typical output of the RCA step is a set of contributing factors that then indicate systemic issues that may be addressed together by policy or process changes.

Standard RCA tools used in the industry include the Five Why method, Ishikawa, or the Fishbone Analysis. Some cases use more advanced techniques like the Swiss cheese model or PRISMA.

14. Contributing Factors

Contributing factors are those factors that influenced a single event or multiple events to cause an incident. If contributing factors are accelerated, it will affect the severity of the consequences. Therefore, with the knowledge of contributing factors, management can eliminate them to prevent similar incidents from occurring in the future.


QUASR implements a form of the
London Protocol for capturing these factors.

15. Executive Summary

The compelling executive summary is the final step in reporting incidents. It is a short document produced for management purposes. It summarizes a more extended report so that readers can quickly become acquainted with the material. Management can get a crisp reading of the incident from the executive summaries without reading the entire report.

Benefits of Hospital Incident Reporting

Through healthcare data analysis, setting the correct key performance indicators in your organization becomes simpler. Here are some vital benefits that you can gain from reporting.

1. Preventive Measures

 

One of the most powerful elements of an incident report is streamlining historical and current data to spot potential incidents in advance. Using predictive analysis, healthcare facilities can improve the quality of patient care and reduce workplace mishaps. Around 60% of healthcare leaders have confirmed that adopting predictive analytics has improved their efficiency considerably.

 

2. Disease Monitoring

 

Disease monitoring is one aspect of the first predictive analytics. With the incident reports, healthcare organizations can monitor potential disease outbreaks by using past and present metrics. 

 

During COVID-19, many hospitals have struggled to prevent disease outbreaks on their premises. But, the organizations that have insightful data with them may have managed the pandemic outbreak a lot easier.

3. Cost Reduction

 

Reporting can also make healthcare operations more economically effective. By gathering and analyzing incident data daily, hospitals’ can keep themselves out of legal troubles. A comprehensive medical error study compared 17 Southeastern Asian countries’ medical and examined how poor reporting increases the financial burden on healthcare facilities.

 

4. Enhanced Patient Safety

 

Improving patient safety is the ultimate goal of incident reporting. From enhancing safety standards to reducing medical errors, incident reporting helps create a sustainable environment for your patients. Eventually, when your hospital offers high-quality patient care, it will build a brand of goodwill.

Healthcare Incident Reporting Challenges

Healthcare incident reporting has various managerial and safety-related benefits. To create a result-driven incident report, you have to cross the next hurdles also:

1. Paper-based Reporting

 

In this technology era, many healthcare organizations still rely upon traditional paper-based reporting. Paper-based reporting is a manual approach where the incident details are recorded and managed using paper and often hand-written reports.

 

Paper-based reporting has numerous disadvantages, including low-quality data, limited flexibility, costly process, error-prone, time-consuming, and more. Get started digitizing your incident data by downloading our Excel-based Incident Reporting Template and quickly replace paper-based reporting. We even have a post explaining the template and how you can benefit from it.

2. Underreporting

The problem of underreporting is widespread in the healthcare industry. Common causes of underreporting include:

1) Lack of awareness about when and what to report.

2) Fear of repercussions from colleagues or seniors.

The reason behind underreporting might vary, but no one can deny that it is the biggest reporting challenge. We had written a detailed article on our assessment of under-reporting in our blog.

According to the
Agency for Healthcare Research and Quality, all healthcare facilities should offer a simple and anonymous reporting way to their staff. QUASR has built-in features to encourage reporting in a pseudo-anonymous manner encouraging staff to file a report without fear.

3. Busy Schedule

 

The busiest hospital personnel, nurses, and doctors are mainly responsible for filing incident reports. Due to their busy and often overworked schedule, they sometimes fail to report incidents. A solution must factor in this constraint at the time of design and implementation to ensure all incidents are recorded in a timely fashion without over-burdening the staff.

Conclusion

After understanding the purpose, benefits, and challenges of incident reporting in healthcare, it is clear that reporting is essential for medical facilities. Whether you wish to improve patient safety or reduce workplace mishaps, incident reporting can serve multiple purposes. But, compiling, reviewing, and investigating incidents in a timely and unbiased fashion isn’t a simple task. 

 

You require an automatic incident reporting system to manage hundreds of incidents at any given time. We can say that QUASR has practical tools to help you create track-analyze incident reports. QUASR is easy to use and access, which allows fast and accurate incident reporting. 


We have various elements in our software for resilient healthcare incident reporting ensuring all the best practices. To better understand what QUASR can do for you,
book a free demo today

 

Also, please stay connected with us as we will be covering more topics related to digitalized incident reporting.


Meanwhile, feel free to
contact us for further information!

Under-reporting Patient Safety Incidents: A Real Problem

Rohini

Amy had been a staff nurse in the same hospital for 30 years. Her shift starts with making rounds in different 15 wards and ensuring they follow all the patient safety protocols.

One day she found water on the Ward No. 3 floor due to the cleaning staff’s negligence. Despite noticing this issue, she keeps on moving with her job.

Her reasons to not report the problem were:

  • – Reporting meant lots of paperwork
  • – Reporting could put her hours behind schedule
  • – She had to waste time on hearing back from the admin department
  • – Importantly, she doesn’t want to cause any trouble to the poor cleaning staff

So, she didn’t report at that time, and the issue remained unresolved. After a few days, some patients fall from the wet floor in the ward. Now patient falls are serious. And it doesn’t look good if the investigation reveals negligence. So, they go unreported as well!

The result? The hospital continues to score poor safety results. The reason for not reporting could be credible or just laziness. Under-reporting doesn’t help the organization meet its safety goals. The story above is not an isolated story of anyone hospital or nurse.

Statistics tell us that this seems to be the norm:

  • – Almost 25% of incidents go unreported. (Source: Sentis)
  • – Around 100 errors go unreported while recording. (Source: Pharmacy Times)
  • – Every year about 7,150 deaths occurred due to not reporting incidents in hospitals.(Source: Yale News)
  • – The Journal of Patient Safety]] suggested in 2013 that 440,000 people per year die from preventable medical errors. (Source: Medscape)

Even though we have data indicating under-reporting in hospitals, not many practitioners follow the proper reporting process. QUASR tries to address this issue with simple tools that seek to address common reasons for under-reporting. Let us first understand Under-reporting and its Reasons.

What is Under-reporting?

Under-reporting means an issue, incident, or the fact that an individual or organization has not reported. Under-reporting is a failure in data gathering.

In hospitals, sometimes individual staff hide or don’t report some incidents. However, unfortunately, it is not possible to know ahead of time how these under-reported incidents affect long-term patient safety.

Recently a study published in the Stanford Business on how hospitals acquired infections is reported in Medicare claims. Researchers found that hospitals with lighter reporting requirements were more miscoded by examining hundreds of Medicare patients, as hospital-acquired infections(HAIs) were presented on admission (POAs). 18.5% of infections said to present upon admission were acquired in the hospital.

Overall, under-reporting is a critical issue that should be analyzed and treated by the hospitals on priority.

4 Reasons Behind Under-reporting in Hospitals

There are plenty of different reasons that generate under-reporting problems in hospitals worldwide. Some of the common underreporting causes in hospitals are:

Fear of Repercussion

One of the most common reasons why an incident goes unreported is a fear of repercussion. We don’t think there are any organizations in today’s day and age where an employee is penalized for taking the initiative.

Still, many staff that we have met on and off have mentioned that they are afraid it will reflect poorly on them if they reported an issue. Organizations may have to do more to ensure that an incident is not a reflection of the staff. From our discussions with our clients, this is often amongst the top few reasons why incidents go unreported.

No Time To Report

Staff on the floor are amongst the busiest people we meet on a given day. Incident reporting in such a dynamic is quite tricky. Most incident forms are lengthy and require the staff to write up in sufficient detail, then participate in multiple investigation sessions to complete the incident report.

Often incident reports have to be filed within a predetermined number of hours since the incident occurred. If they cannot do this, they usually forget and don’t get around to filing the same. It is especially true for incidents that don’t cause any harm to the patients as such since everyone’s priority is patient safety and care.

Hospital staff often do not have time, and hence they may tend to ignore incidents that they believe are not serious enough. Lack of time is also one of the top reasons why under-reporting occurs, based on our discussions with our clients.

Lack of Transparency

Often the reporting person is wholly left out of the incident processing loop. Many organizations have a perfect reason to do this for some types of incidents too. But some processes are not designed to be transparent at all. The process leaves many people out, and they don’t understand how their reporting an incident helped the organization or patient benefit. This can also lead the staff to believe that their incident report went into some “filing black hole”, and no one even had a chance to process their report.

It is possible to revise the incident process to be more transparent when it is digitalized. A digital system allows for frequent and early feedback to all the stakeholders. By being transparent, the system becomes more inclusive of all staff and helps them realize the value of their contribution.

Insufficient Training or Knowledge

Many healthcare institutions are unaware of the fact that their incident reporting system isn’t transparent. Not many hospital staff members know when, how and whom to report. The lack of reporting knowledge occurs due to poor communication.

Most hospitals would share this information with their new workers during the orientation and training process. But learning occurs differently to different people. Often, a single knowledge sharing session is insufficient to orient all the users in the processes.

Additionally, organizations share critical information via email. Frontline workers like nurses or ward attendants don’t have regular access to a computer to receive information on time.

The only way to address this is continuous training or frequent sessions to help the staff get oriented to new systems better. The other often ignored method is to build intuitive systems.

How does QUASR help you address under-reporting?

QUASR has a suite of nifty tools integrated into the system to help address under-reporting. For instance, to specifically address the fear of repercussions, QUASR uses a novel pseudo-anonymous reporting that allows users to hide their identity at the time of reporting. We do this so that the users will feel safe reporting, but at the same time, the Quality Managers don’t have to deal with insufficient data for investigation later on.

Similarly, we use a multi-stage questionnaire for collecting the details with the ability to resume your data at any step. This allows staff to fill in the incident report over multiple breaks without blocking off a significant portion of their time to do this.

QUASR, at its core, believes that an incident management system is an essential knowledge repository for the healthcare organization to learn from and disseminate information over. So transparency is one of the critical considerations of the design with suitable mechanisms to protect sensitive data when the need arises.

Finally, QUASR aims to keep the application simple in appearance and manner. The bottom line consideration for every element added into QUASR is the amount of training each user would need to use that element effectively. We have designed the user interface in line with some of the social applications familiar to us. This allows us, the users, to quickly adopt and start using QUASR with minimal training efforts.

We will be covering some of these features like pseudo-anonymity or sensitive incidents in individual blog posts in the future. So do watch this blog for more information.

Meanwhile, feel free to contact us or drop us a note if you need further information on any of these topics in particular or QUASR in general!

An Introduction to QUASR Basic

Abishek Goda
Basic-Features-Banner

When we brainstormed the QUASR Lite design, we had a list of features for another version that’s slightly more advanced than Lite but not as involved as the Premium version. Even amidst our customers and prospects, we understand Lite is a little too simple for their process because they have had a computerized system in place for a while and are familiar with the advantages of having one. They need to upgrade but are not ready to set aside budgets or time for enterprise implementation.

So we built QUASR Basic to give you a flavor for what the enterprise system can do for you without having to go through full implementation. There are limitations, of course. In this post, allow us to introduce QUASR Basic to you.

QUASR Basic is Lite with an automated workflow

QUASR Basic is Lite with a workflow. It does not have all Premium version features and will probably remain that way for more time. BASIC and Premium target different types of organizations.

BASIC targets single/independent hospitals, which are:

 

1) accustomed to having a system in place.

2) using Lite for a while and want to graduate their process.

3) Enterprise-ready users who wish to try QUASR before taking on an enterprise implementation.

 

I hope we convinced you to read on, as this might be just what you need at your org right now.

 

What do we mean by a workflow anyway?

In Lite, when you report an incident, the system doesn’t do much apart from saving it to a database and ensuring the data’s integrity. In BASIC, however, a few things happen: the system triggers an email to a pre-designated group of Quality Managers as soon as you report an incident.


The incident details collected also contain additional information such as the Supervisor for the incident, a team of investigators, a group of people to sign off on the incident etc. Each of these is a stage in the incident lifecycle. The Supervisor assigned is then required to perform the review and fill in the SBAR. Similarly, upon quality review completion, the investigation report can be updated and so on. This linearizing sequence of events in the incident lifecycle is what we call the “workflow”.

There’s more to QUASR Basic compared to QUASR Lite

But that’s not all of it either. There are more things under the hood in BASIC as compared to Lite. Flags assigned to incidents in Lite are merely indicators. They help you identify or classify incidents at a glance. However, in BASIC, you can use Flags to include pre-designated people in the incident loop. They’d automatically get notifications and access to the incident details.

Similarly, you can add other users to the incident and notify them of the occurrence – voluntarily. These might be other department heads or an HR supervisor or a Line supervisor instead of the department supervisor. These users would otherwise not have access to the incident or its details.

 

One last thing to highlight about Basic would be the “Sensitive Incidents” feature. We will write a detailed note on sensitive incidents in another post in the future. But for now, sensitive incidents are a type of flag that limits the access to the incidents to a predetermined group of users – Quality Managers, investigators and other management level users. QUASR does not have an opinion on how or when to use this flag. We leave it to our customers to use it as they see fit in their organization.

QUASR Basic vs QUASR Premium

Lastly, as I mentioned, BASIC is Lite with automated workflow.

 

But how does Basic compare to Premium?


Premium
targets a group of institutions as opposed to independent hospitals or providers. A group has other requirements in terms of uniformity of process across their participant hospitals. They tend to prefer a single cluster implementation where the group management can get their dashboard with the essential information they need about the overall incident performance.


BASIC, on the other hand, does not support a cluster implementation. There are other differences in terms of support access, implementation, customization provisions in Premium that aren’t available in Basic.

For more information, check our pricing page, and it’d be able to give you even more clarity on both these versions and options.

How To Create-Track-Monitor Incident Report Using Excel?

Rohini

Incident Reporting in Hospitals

In the healthcare industry, incident reporting is an important task that records all the unusual events occurring at hospitals, nursing homes, and other medical facilities. An incident report is a formal report written by practitioners, nurses, or other staff members to inform facility administrators of incidents that allow the risk management team to consider changes that might prevent similar incidents. The forms used for incident reports are either paper forms or electronic.

Despite all the advances in medical technologies, Incident management remains a paper-based manual process in many hospitals. We understand that multiple factors drive these decisions. We talk about the effects of a paper-based vs a digital system on the incident reporting process here.

The first knock of a transition from paper medical records to electronic come after the American Recovery and Reinvestment Act (ARRA) 2009. This law encouraged healthcare providers in the United States to digitize internal record systems and develop a centralized database so that doctors, physicians, and nurses can easily access health records. 

However, moving from a paper-based system to a paperless one isn’t that simple and easy. That’s why many healthcare facilities haven’t gone completely paperless even after a decade of modern record system. They might be trying to avoid a few hurdles, but in reality, they are facing multiple challenges daily with the paper-based method, such as:

  • Time-consuming
  • Ineffective Data Presentation
  • Not scalable
  • Limited security
  • Missing Audit trail and tracing
  • Prone to error
  • Difficult to analyze

Therefore, healthcare facilities required fast, secure, and quick incident reporting. In short, they need an automated incident reporting system. But, as of now, only two-thirds of hospitals have focused on automation. 

Create-Track-Monitor Incidents using Excel

We have been working with healthcare facilities for years now, so we duly understand that automation isn’t an easy task. It is an expensive and technical process that not all hospitals can adopt.

We are here to help you with an alternative, that won’t cost you a dime. A free, reliable, and effective incident management system for medical facilities— Excel reporting.

For hospitals that are not yet ready to dive into software systems for incident reporting, using Excel is an inexpensive and reliable option, as it can quickly get you off the ground. In this article, we’ll discuss how you can use Excel to maintain and track your incidents.

To manage all incidents in one place, and analyze them effectively, the quality manager needs to organize different sets of data to draw conclusive statistics. However, when incidents are recorded in papers, analyzing the data or locating patterns is a daunting task. Thus, a need for meaningful data emerges where data is easily readable and interpretable.

For Example—

In a paper-based reporting, an incident description will be recorded like this:

“A Patient A was sleeping on his bed in Ward No. 2. While turning in his sleep, he fell from the bed. The attending nurse immediately rushed to him and helped him get back onto the bed and put the bed rails up. The patient did not sustain any injuries.”

Now, if same information is captured in structured format, it will look like this:

Incident Type: Patient fall
Incident Subtype: Fell from bed
Incident Location: Ward 2
Affected People: Patient A
Injury: None

It is evident that the data recorded in the second style is easier to navigate, analyze and interpret. Therefore, the way you record data makes a huge difference in the analytical process.

If you are using paper forms for reporting and managing incidents, we have even eased your  work by creating an Incident Report Excel Template along with a process to custom create incident reports in Excel.

How to structure your data

When you want to gain insightful information from an incident report, you have to record every minute detail in it. However, the amount of report details depends upon your organization’s size, patient safety goals, claim frequency, and other relevant factors. In a hospital incident report, it is essential to add the following details:

Incident occurrence date

The well-informed incident report needs basic information such as the date and time of the incident. This is one of the most important pieces of information especially useful to calculate statistics and performance.

Location of the Incident

Specifically, mention the location of the incident along with the particular area within the hospital—for example, patient X fall in Ward no. 2 near the bed. When you use Excel, it is a good idea to make the Location field into a dropdown field. Generate a list of all possible locations, from the lift lobby to OT, and select from the values, rather than typing it as text. This helps you to convert ‘Location’ into a measurable field and you can generate statistics out of it, such as, “What is the most prone location for a fall?”.

Type of the Incident

This is the key information that will help you in analyzing and processing your data, as well as generating your statistics for the management. You can categorize the incidents as Medication Error, Patient Fall, Equipment Damage, Patient Identification, etc. When you use Excel, it is a good idea to make the Incident type field into a dropdown field. Create a list of all the incident types you want to capture and select from the values, rather than typing it as text. This helps you to convert ‘Incident Type’ into a measurable field and you can generate statistics, such as, “What is the most common incident in my hospital last year?”.

Parties Involved in the Incident

The name and contact details of all the parties involved in the incident to follow up. If there are witnesses available to the incident, it will be helpful to add their statements in your report. While writing witness statements, focus on the following attributes—specific details provided related to the incident, use quotation marks to frame their statements, note witnesses’ location at the time of the incident, and how they are related to the incident.

Detailed Incident Description

The incident description is provided by the person who reported the incident. This can be as detailed as it can get, as more the information in hand, the better it is to investigate it further.

Comments

Once you have all the information from the reporter, you can track the incident in excel by recording all the follow-up discussions, comments given by Supervisor or other managers all in one single row in excel!

Risk Assessment Score

Whether you use a 5×5 Risk matrix or a SAC scoring of 1 to 4, you can enter the severity risk score against the incident, again in the same row!

Contributing Factors

Except for minor incidents, everything else will most likely go through a root cause analysis and investigation process. It is a good practice to maintain a list of all the Contributing factors, (either London Protocol or you can follow your hospital guidelines) and select from the values, rather than typing it as text. This helps you to convert ‘Contributing factors’ into a measurable field and you can generate useful statistics, such as, “What is the top contributing factor for my incidents?”.

What is Meaningful Data?

Meaningful data is, in simple terms, usable statistics and actionable insights that can be used to evaluate the efficiency and effectiveness of your process. The meaningful data answers numerous aggregated questions, provide you useful insights without many efforts

  • How many fall incidents happened last month?
  • How many medication errors occurred last year?
  • What percentage of incidents are still open?
  • What is the most common occurrence?
  • Which location is prone to more falls?

As we have cleared in the above example that paper-based recorded data can’t help you find aggregated results without spending hours or days of effort. But, with excel, you can utilize the features such as a drop-down list and data filters to derive this meaningful information quickly.

Download our ready-to-use Excel template

If you don’t know how to turn a vanilla Excel spreadsheet into an incident report sheet, do not fret! Download our ready-to-use Incident Manager Template. The template contains all the information that you minimally need to capture and provides some incidents for reference. You can customize the template to suit your needs, especially the parent list of incident types, list of departments, and statuses. In the following sections, we also explain how you can do this.

However, if you want to build your own custom incident manager spreadsheet from scratch, read more as we walk you through the process.

Customize your Incident Manager Excel template

How to Create a Drop-down for Columns?

Drop-down is a very useful Excel feature where you can sort relevant information based on your requirements. For instance, using our template you can easily sort information based on incident type and contributing factors. However, to create a custom drop-down list, you can follow these steps:

  • Select the cells that you want to contain the lists.
  • On the ribbon, click DATA > Data Validation.
  • In the dialog, set Allow to List.
  • Click in Source, type the text or numbers (separated by commas, for a comma-delimited list) that you want in your drop-down list, and click OK.

Here is a video explaining this step by step.

How to Use Filter Function?

The filter function allows users to easily extract matching records from a larger set of data based on certain criteria. Suppose you want to know how many open incident cases were present in Ward No. 2, our incident template will immediately show you—just follow these instructions:

  • Select any cell within the range.
  • Click on Data > Filter.
  • Next, select the column header arrow.
  • Now, you can choose between Text Filters or Number Filters.

For eg. To know the number of open incidents, you should select the Status field and select ‘Open’ (unselect ‘Closed’).   To know the number of such open incidents in Ward 2, you should select the Location field and select ‘Ward 2’.  Now you have the narrowed down list of Open incidents from Ward2.

How to Create a PivotTable?

In Excel, you can use PivotTable to calculate, summarise and analyze data present in your report. Additionally, you can easily compare and find trends in your data. With our template, you can create Statistics on Incident Types or by departments or by status.

PivotTable works a little different depending on what platform you are using to run Excel, but the simple way to create PivotTable is:

  • Select a cell where you want to create PivotTable.
  • Select Insert > PivotTable.
  • Under Choose the data that you want to analyze, you can Select a table or range.
  • Verify the cell range in Table/Range.
  • Under Choose where you want the PivotTable report to be placed, you can select a new worksheet or an existing one to add PivotTable and select OK.
  • You can add fields to your PivotTable, click on the field name checkbox in the PivotTables Fields pane.

How to Refresh PivotTable?

When you add new information to our pre-made worksheet, you need to refresh the PivotTable to provide updated statistics to you. To refresh PivotTable:

  • Click anywhere on the PivotTable to appear the PivotTable Tools ribbon.
  • Select Analyze > Options.
  • Go to the Data tab, check the Refresh data when opening the file box.

How to Create Graphs?

To better analyze incident data, you can convert it into a graph and chart with our template. The graph can be created in Excel as:

  • Select a cell.
  • Choose a graph from the nine graph and chart options.
  • Highlight your data and click on ‘Insert.’
  • Adjust data’s layout and colors.
  • As per your requirements, change the size of the graph and axis labels. 

Here is a video that explains this step-by-step

Download template

Get started today by downloading this Incident Report Template we created for you to easily start managing your incidents. The template contains all the minimal information that you need to capture. You can customize this template to suit your needs, especially customizing the parent list of incident types, contributing factors, list of locations, and departments. 

QUASR Lite

QUASR Lite is the simplest online incident managing software you have been looking for. The main advantage QUASR Lite brings to you over vanilla excel sheets is that: we have built it specifically for hospital incident scenarios. We consolidated our experience working with many hospitals and created a starter tool that will grow with you as you mature into bigger and more involved processes. You’ll be able to attach evidence, share reports with selected staff or departments and notify senior management of serious incidents. Since it is digital, you can effortlessly search, sort, or churn statistics for those important management meetings.

QUASR Lite is aimed at organizations that are just getting started or wanting to digitize their incident management process. Whether you have a simple paper-form method or looking to create your own structure and process, QUASR Lite has you covered.

Check out more features of QUASR Lite. You can sign up for a 14-day free trial 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.

Moving from a paper-based system to a digital system

Rohini
paper digital system

Despite all the advances in medical technologies, Incident management remains a paper-based manual process in many hospitals. We understand that multiple factors drive these decisions. There is no single reason why any hospital continues on a manual process. 

Let us briefly describe the incident reporting process in a hospital. A reporter/witness has to fill in a paper form with as many details as possible. The quality team then reviews the report and collects other witness accounts and additional supporting information from the supervisor(s). Based on the data collected, the quality team performs risk assessment.

At this stage, the quality team also decides whether the incident requires a more detailed, structured investigation. In cases where an investigation is not needed, the record is closed and filed for archival. But when an investigation is required, the quality team identifies a team of investigators: a group consisting of just the quality team or a team of individuals from across functions. This is the standard process followed in most hospitals, with some having variations to cater to their operations. This process can be followed either manually, which we call a paper-based system, or digitally, with the help of a software.

This article expounds on the effects of a paper-based vs a digital document system on the incident reporting process and the various aspects to consider when moving from a paper-based system to a digital system.

Paper-based system

In simple terms, a paper-based system is one where information is kept on paper, rather than on a computer. 

Let us take the example of a hospital that uses a paper-based system for incident reporting. As you can see above, in every stage of an incident, the incident form (paper) is passed around to various stakeholders. Each stakeholder gets a copy of the incident form based on which they create their reports. The quality team collects all these individual reports and then files them together as part of the incident report. Each step involves moving paper, tracking them carefully across many staff. The process usually takes a few weeks until closure.

With paper forms stored in files and folders, there is no simple way to locate a specific report involving a particular patient or generate statistics or identify any patterns. As a quality manager, suppose you want to analyze incidents from the past year and develop a set of guidelines or device process improvements so that some incidents do not happen in the future. There is no easy way to do this when you deal with paper forms. By practice, the quality team identifies common incidents and recommendations for preventing those. But to effect the changes, the quality manager has to collect conclusive evidence and statistics to highlight the pattern. With paper-based incident reports, this is a few weeks of effort to collect the required data and present it to the management. 

Keeping track of paper documents is not only a hassle but a waste of time and resources. Additionally, the data collected is relatively low quality in nature due to legibility issues. Safe storage from various hazards, securing from unauthorized staff only increases the complexity.

Digital system

In simple terms, a digital system is a system that stores the data in a searchable format on computerized storage. This storage could be on a local computer, on a server or the cloud. A Searchable format can be anything ranging from a simple Word document or an Excel sheet, a text document, or an elaborate record-keeping system on the cloud.

The same incident process: collaborating with multiple stakeholders, investigation reports, gathering statistics and identifying patterns become far more straightforward with a digital system. It is also simple to collect and manage all types of incidents – major or minor – leading to identifying issues that otherwise go unreported. 

The quality of the data collected is better, and it is effortless to avoid duplication. The data may be accessed from anywhere while enforcing sufficient levels of security and authorization. It is also possible to restrict access to specific data and get visibility to all the modifications made. Moving to a digital system saves time, effort, resources and enables collaboration. It also helps improve communication and brings in better accountability.

How to choose a digital system?

At this point, the motivations to go digital are quite apparent. The critical question, then, is – how does one choose the right digital system? Our answer is: start small. The transformation process is quite involved and can be daunting if we accounted for all the factors in the first attempt. There are also factors about data storage location and format to use. Our recommendation is to start with the most comfortable and familiar format: Excel Sheets. Manage the sheets on the local laptop/desktop or a network shared folder. Just doing this is already a successful first step to the transition to a digital system.

It is essential to build a habit of collecting the required data digitally using the newly devised system. It is easier to improve the system and the process to collect all the right data with regular use. Having the right data is the first step to identifying the system that suits the process in place. While digital data storage comes with many benefits, there are downsides based on the actual system in place. 

To understand this better, let us take a case where we use Excel sheets for managing incidents. For all the benefits that Excel offers, it is quite challenging to “organize” data effectively. Often it is possible to end up with multiple versions of a file shared over emails leading to merging efforts. Further, charting or pivoting the data requires significant knowledge and skill with Excel itself.

Do watch this blog for an article on managing incident data effectively using Excel sheets.

We can address some of these complexities by using other tools like Google Forms or repurposing project management apps to manage incidents. For the technically savvy, bug tracking systems commonly used in software development companies are also a good starting point for incident management systems.

To conclude, the benefits of a digital system far outweigh the perceived convenience of a paper-based system in almost all aspects. However, transitioning to a digital system need not be a daunting task if it is taken one step at a time. Picking the right tools to aid in the transition by leveraging familiarity is an excellent way to get started quickly.

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.