International comparative analyses of incidents reporting systems for healthcare risk management
Article first published online: 1 MAR 2011
© 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University
Journal of Evidence-Based Medicine
Volume 4, Issue 1, pages 32–47, February 2011
How to Cite
CHENG, L., SUN, N., LI, Y., ZHANG, Z., WANG, L., ZHOU, J., LIANG, M., CUI, X., GAO, G. and YUAN, Q. (2011), International comparative analyses of incidents reporting systems for healthcare risk management. Journal of Evidence-Based Medicine, 4: 32–47. doi: 10.1111/j.1756-5391.2011.01119.x
- Issue published online: 1 MAR 2011
- Article first published online: 1 MAR 2011
- Accepted manuscript online: 18 FEB 2011 06:31AM EST
- Received 07 January 2011; accepted for publication 27 January 2011.
- healthcare risk;
- warning and monitoring;
- management model;
- comparative analysis
Objective To compare administration of incidence reporting systems for healthcare risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, and to provide evidence and recommendations for healthcare risk management policy in China.
Methods We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews, and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents.
Results (1) A total of 142 documents were included in this study. The United States had the most relevant documents (68). (2) The type of incidents from reporting systems has expanded from medication errors and hospital-acquired infections to near-misses, and now includes all patient safety incidents. (3) The incidence-reporting systems can be grouped into two models: government-led and legal/regulatory/NGO-collaborative. (4) In two cases, reporting systems were established for specific incident types: One for death or serious injury events (the sentinel events database in Britain, SIRL), and one for healthcare-associated infections (NHSN in America). (5) Compared to the four countries, Taiwan's system put more emphasis on public welfare, confidentiality, and information sharing. The contents of reporting there covered every aspect of risk management to create a more secure environment.
Conclusion (1) Britain's national reporting and learning system was representative of a government-led model; (2) The United States was the earliest country to have a reporting system, which included a limited range of incident types. Management of incidents became more reliable with increased application of laws, regulations, and guidances; (3) Both the Canadian and the Australian systems drew from the American experience and are still developing; (4) The Taiwanese system was comprehensive and is an instructional case.