INCIDENT REPORTING ON THE ACUTE CARE SETTING
Healthcare risk management is an effort that is organized in a bid to identify, evaluate and reduce risk to patients, employees and visitors alike. The biggest asset of a hospital (besides the equipment the hospital owns) is the reputation it holds. The Florida Statute for risk management (Cap 395.0197) requires that each licensed medical facility is to have an internal risk management program led by the risk manager. The risk manager’s duty is to reduce and if possible prevent risk, and to enhance the safety of the patient. The risk manager carries out evaluation and control of risks through an incident reportage system, tracking and trending, reporting to the relevant board as provisioned by the Agency for Health Care Administration (AHCA). An incident is defined as an event that occurs outside the confines of normal routine of a hospital, regardless of whether or not it causes injury to a patient, visitor, or employee. An incident report on the other hand is a discretion report that outlines the details of an event to a healthcare risk manager. By the report being confidential, it means that the details of the report shall not, under whatsoever legal docket, be used as evidence. Even if an attorney asks for the report, the manager is in a position to decline submission of the report, as it is by law a confidential document.
According to the Florida Law it is the duty of all healthcare providers to report an incident within 3 business days after occurrence. Education is extended to employees on matters regarding incident reporting, 30 days after being hired, and every year after that. The incident report includes details such as name, age, sex, location during incident, concise and specific description of what happened. An incidence report is to be categorized into specific sections to aid in analysis. A risk management program must also investigate and analyze the frequency of occurrence of incidents. A risk manager is required to submit an annual report on April 1 of each year giving a summary of the received incident reports. A risk manager should also review all the reports coming in, or if not in the capacity, delegate someone to do it. Risk management is a data framework - all the reportage of incidence reports are better explicatory if they are backed up by concise and detailed data. This requires the risk manager to be proactive about data analysis. Committees are a conceptual provision with which it is considered good practice for the risk manager to engage in. The committees may have different groups of people e.g. employees and as such the risk manager can obtain concrete data with regard to grievances, care quality, safety, ethical issues, legal issues etc. These committees provide a basis for the exercising of corrective action as a risk manager.
Adverse events are defined under FS 395.0197 as an event that healthcare personnel can exercise control associated wholly or partly to medical intervention. It results to death, wrong procedure, wrong patient, brain damage, spinal damage, or any surgical procedure that is otherwise unrelated from what the patient suffers from, surgical procedures to remove foreign objects, fracture and/or dislocation of bone or joint etc. These are collectively called “code 15” events since they are required to be reported to AHCA within 15 calendar days, and will also be reported annually in the April 1 submission report. Reportage to AHCA can be done online as well as using telephone. A code 15 fill out application form can be downloaded, printed out and then filled in by hand. Patient information needs medical records which can be obtained from a face sheet and then filled out. A description of the event is required in the form which then requires one to fill a factual synopsis that is concise and not emotionally biased.
The first section highlights the victim details, and the second section is for the witnesses that were present at the time of the occurrence of the event. The form is then to be signed by the risk manager. AHCA will contact the risk manager for more details, if need be, or carry out an inspection of the facility. This inspection is related to the nature of the adverse event. A request for extension form is also available for the risk manager in case time runs out without having concrete factual details of an adverse event. The time provided for the extension can be varied according to the time requested by the manager.
Annual Report
This is a more complex piece of document required by AHCA every year as an update of events that are serious, even if they do not qualify as code 15 events. Such events include fractures, permanent disfigurements, surgical complications, especially those resulting after surgery e.g. intravenous infiltration, events requiring immediate medical attention even if it occurred non-conventionally etc. Annual reports do not trace back to the patient unlike code 15 reports, which require personal information and hence can be tracked back to the patient. To know whether an event is admissible to be reported to AHCA as a risk manager, what ought to be known is whether the event is under control of the medical practitioner. If the event is under the control of the health care provider, then the event is reportable, and if not then it is not.
Works Cited
Incident Reporting - State and Regulatory Requirements - Acute Care Setting. Incident Reporting - State and Regulatory Requirements - Acute Care Setting. N.p., n.d. Web. 20 Jan. 2017. <https://ucfce.instructure.com/courses/1045140/pages/incident-reporting-state-and-regulatory-requirements-acute-care-setting?module_item_id=7632334>.
