What are Incident Management Systems?
Incident Management Systems (IMS) in healthcare are structured processes used to identify, report, investigate, and resolve incidents or near misses in healthcare settings. These systems aim to improve patient safety and care quality by learning from these incidents (Australian Commission on Safety and Quality in Health Care, 2023).
What is Open Disclosure?
Open Disclosure is a practice in healthcare where healthcare providers openly communicate with patients and their families about incidents that resulted in harm to the patient during care. It involves an honest, empathetic, and timely explanation of the incident and the steps taken to manage and prevent future occurrences (Australian Commission on Safety and Quality in Health Care, 2023).
Importance of Incident Management Systems and Open Disclosure
Effective IMS and open disclosure practices are critical in maintaining transparency, trust, and accountability in healthcare. They contribute to patient safety, enhance learning from adverse events, and foster a culture of continuous improvement in healthcare organisations (National Safety and Quality Health Service Standards, 2023).
What is the "Incident Management Systems and Open Disclosure" Training Requirement?
Training in IMS and open disclosure is mandated under NSQHS Standards, particularly Actions 1.11 and 1.12, and under the Aged Care Standards Requirement 8.3 (d). Training ensures that staff are competent in identifying, reporting, managing incidents, and communicating effectively with patients and families (Aged Care Quality and Safety Commission, 2023).
Relevant Standards
Action 1.11: Incident management systems and open disclosure
The health service organisation has organisation-wide incident management and investigation systems, that:
- Supports the workforce to recognise and report incidents
- Supports patients, carers and families to communicate concerns or incidents
- Involves the workforce and consumers in the review of incidents
- Provides timely feedback on the analysis of incidents to the governing body, the workforce and consumers
- Uses the information from the analysis of incidents to improve safety and quality
- Incorporates risks identified in the analysis of incidents into the risk management system
- Regularly reviews and acts to improve the effectiveness of the incident management and investigation systems
Action 1.11: Incident management and open disclosure
The health service organisation:
- Uses an open disclosure program that is consistent with the Australian Open Disclosure Framework
- Monitors and acts to improve the effectiveness of open disclosure processes
National Safety and Quality Health Service (NSQHS) Standards
Requirement 8.3 (d): Risk management systems:
- (i) managing high-impact or high-prevalence risks associated with the care of consumers
- (ii) identifying and responding to abuse and neglect of consumers
- (iii) supporting consumers to live the best life they can
- (iv) managing and preventingincidents, including the use of an incident management system.
Action 1.2.3: Elder abuse / incident management
The provider implements a system to recognise, prevent and respond to violence, abuse, racism, neglect, exploitation and discrimination.
Action 2.5.1: Incident management systems
The provider implements an incident management system to record, investigate, respond to and manage incidents and near misses that occur in connection with the delivery of care and services and reduces or prevents incidents from recurring.
Action 2.5.2: Responding to and managing incidents
The provider takes timely action to respond to and manage incidents.
Action 2.5.3: Supporting client incident reporting
The provider supports older people, family and carers to report incidents and encourages their involvement in identifying ways to reduce incidents from occurring.
Action 2.5.4: Supporting workforce incident reporting
The provider supports the workforce to prevent, recognise, respond to and report incidents.
Action 2.5.5: Provider incident management reporting
The provider collects and analyses incident data. Outcomes are reported to older people and workers and feed into the provider’s quality system to improve the quality of care and services.
Action 2.5.6: Reviewing and improving incident management systems
The provider regularly reviews and improves the effectiveness of the incident management system.
Strengthened Quality Standards framework analysis - Aged Care Quality Standards
Failure to comply with the requirements could lead to an organisation being penalised or reprimanded.
Related Training Requirements Guides
The following Training Requirement guides can be used to support and facilitate the "incident management and open disclosure" training requirement:
Skills Required for Incident Management Systems and Open Disclosure
The effectiveness of Incident Management Systems and open disclosure in healthcare largely depends on the specific skills possessed by the staff. These skills not only ensure compliance with regulatory standards but also foster a culture of safety and transparency. The following list outlines the key skills required for effective implementation of IMS and open disclosure:
- Communication Skills: Ability to convey information clearly and empathetically, particularly in sensitive situations.
- Risk Management: Identifying and addressing potential risks before they escalate into incidents.
- Problem-Solving: Analysing incidents to find root causes and develop effective solutions.
- Emotional Intelligence: Understanding and managing one's own emotions and recognsing their impact on others, especially during crisis management.
- Teamwork: Collaborating effectively with colleagues to manage and resolve incidents.
- Legal Knowledge: Understanding the legal implications and requirements surrounding incidents in the healthcare setting.
- Ethical Decision Making: Making decisions that align with ethical standards and patient care protocols.
How to Assess Staff Competency in Incident Management Systems and Open Disclosure
Assessing the competency of staff in handling IMS and open disclosure is crucial for maintaining high standards of patient care and safety. A robust assessment framework ensures that staff members are not only aware of the procedures but are also able to apply them effectively in real-world situations. The following table highlights key methods and tools used for competency assessment:
| Method/Tool | Description | Application |
|---|---|---|
| Regular Training Evaluations | Assessment of knowledge and understanding post-training sessions. | Ensures retention and understanding of training material. |
| Role-Playing Scenarios | Simulated real-life situations to test responses and decision-making. | Assesses practical application in a controlled environment. |
| Feedback Mechanisms | Collection of feedback from peers, supervisors, and patients. | Provides a comprehensive view of performance and areas for improvement. |
| Performance Reviews | Regular appraisal of performance against set standards. | Identifies long-term competencies and development needs. |
| Continuous Professional Development (CPD) Tracking | Monitoring ongoing learning and development activities. | Ensures ongoing skill development and knowledge updation. |
Strategies to Support Healthcare Staff Develop Skills in Incident Management Systems and Open Disclosure
To ensure that healthcare professionals are equipped with the necessary skills for effective IMS and Open Disclosure, organsations must implement targeted skill development strategies. These strategies not only enhance individual capabilities but also contribute to the overall safety and quality of healthcare services. The following list provides a comprehensive approach to skill development:
- Structured Training Programs: Regular workshops and training sessions focusing on key care planning skills to improve knowledge and practical skills among staff.
- Mentorship Programs: Pairing less experienced staff with experienced practitioners for hands-on learning experience and guidance in real-world settings.
- Access to Resources: Providing staff with guidelines, manuals, and access to online resources to enhance self-learning and reference materials for care planning.
- Reflective Practice and Feedback: Encouraging staff to reflect on their practice and receive feedback for continuous improvement in care planning skills and patient outcomes.
Sample Training Plan for the Incident Management Systems and Open Disclosure Requirement
A structured training plan is essential for developing skills in for the incident management systems and open disclosure requirement.
Using the above needs assessment survey as an example - The skill requiring the most attention for incident management systems and open disclosure are communication skills and risk management skills. We can target learning initiatives to fill these gaps to enhance staff competency.
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Staff Competency Assessment for Incident Management Systems and Open Disclosure - Example
To evaluate an individual's skills in operating incident management systems and open disclosure, consider using these survey questions:
Staff Survey - Incident Management Systems and Open Disclosure Competency
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Describe the steps you would take following an incident in a healthcare setting.
- [Answer here]
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How would you approach open disclosure with a patient or their family after an incident?
- [Answer here]
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What are the key components of an effective incident report?
- [Answer here]
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Explain how you would contribute to a culture of safety and continuous improvement in your workplace.
- [Answer here]
Conclusion
Implementing effective IMS and practicing Open Disclosure are integral to enhancing patient safety and care quality. Training and ongoing development of these skills are vital in ensuring that healthcare professionals are equipped to handle incidents professionally and empathetically (National Safety and Quality Health Service Standards, 2023).
References
- Australian Commission on Safety and Quality in Health Care, 2023. 'Clinical Governance Standard'
- Australian Commission on Safety and Quality in Health Care, 2023. 'NSQHS Action 1.11'
- Australian Commission on Safety and Quality in Health Care, 2023. 'NSQHS Action 1.12'
- Australian Commission on Safety and Quality in Health Care, 2023. 'The Australian Open Disclosure Framework'
- Aged Care Quality and Safety Commission, 2023. 'Requirement 8.3 (d)'
- Aged Care Quality and Safety Commission, 2023. 'Stronger Standards, Better Aged Care Program - Action 1.2.3'
- Aged Care Quality and Safety Commission, 2023. 'Stronger Standards, Better Aged Care Program - Action 2.5.1-2.5.6'
