Reporting system for critical incidents in cross-sectoral healthcare (CIRS-CS): pre-test of a reporting sheet and optimization of a reporting system

• Published in: Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen Fortbildung und Qualität im Gesundheitswesen, 2019-11, Vol.147-148, p.58-66
• Main Authors: Manderscheid, Lisa, Meyer, Sarah, Kuypers, Mark, Köberlein-Neu, Juliane
• Format: Article
• Language: English
• Subjects: Checklist; Cognitive interviewing; Critical incident reporting systems; Cross-sectoral healthcare; Delivery of Health Care; Emergency Medical Services; Germany; Humans; Interprofessional relations; Interprofessionelle Kommunikation; Kognitive Interviews; Meldesystem für Fehler und unerwünschte Ereignisse; Patient Safety; Patientensicherheit; Risk Management - methods; Risk Management - standards; Sektorenübergreifende Gesundheitsversorgung; Self-Assessment
• ISSN: 1865-9217; 2212-0289
• DOI: 10.1016/j.zefq.2019.11.002

Potential sources for errors or critical incidents in healthcare may arise not just within a healthcare facility, but also between healthcare facilities (e. g., in the communication between in- and outpatient care). This study aims to test the content validity of the reporting sheet and to optimize the cross-sectoral critical incident reporting system (CIRS-CS). The CIRS-CS was developed as a part of the project “solimed ePflegebericht” based on the expertise of the participating organizations as well as existing literature and existing reporting systems (e. g., the recommendations of the “German Coalition for Patient Safety”). In addition, a pre-test was conducted among the organizations participating in the “solimed ePflegebericht” to assess the content validity of the reporting sheet. Content validity was assessed using cognitive interviews (N=11) with health professionals. The interviews were conducted on the basis of predefined scenarios and probing questions. The reporting sheet that was used for the pre-test consisted of 16 components such as reason for reporting/description of the problem, location of the patient at the time of reporting and suggested solution to the problem. The results of the pre-test indicated that participants found it challenging to relate to components such as In which type of healthcare service did the problem occur, What was the cause of the problem and Which factors contributed to the problem. For instance, some participants found it difficult to decide in which type of healthcare service (e. g., emergency care, routine care) the underlying problem occurred as this component could be reported from different perspectives, i. e. where the incident arose versus where the problem occurred. Thus, depending on the interpretation of this component, the participants questioned the feasibility since there was a lack of knowledge as to under which circumstances the incident arose. The results of the pre-test of the CIRS-CS suggest that the description of the causes as well as potential solutions via the cross-sectoral reporting sheet is unfeasible and may be better approached with an interdisciplinary investigation team panel as part of the reporting system, in which the participating representatives are able to enter a structured dialogue based on the reported problems. Furthermore, the results indicate that investigation team panels enable an interprofessional exchange and may thus promote transparency between healthcare facilitie