Gisborne Hospital Report - Health and Disability Commissioner

Chapter 3
Incident Reporting and Complaints Procedure
1. INTRODUCTION
1.1 Tairawhiti Healthcare’s intention to continuously improve aspects of incident
reporting is evident from its Business Plans. Complaint management and
incident reporting were identified as components in the 1999-2000 Business
Plan. This was followed in the 2000-2001 Business Plan with an emphasis on
the education and training of staff in the use of the incident and complaint
process.
1.2 Up until mid 1999 the incident reporting process was a manual, paper based
process, which was co-ordinated by the Occupational Health team. In
February 1999 responsibility for the incident reporting system was transferred
to the Quality Co-ordinator and from July 1999 information technology was
used to support the incident reporting system. A dual system (manual and
electronic) was maintained initially, to ensure effectiveness of the new
approach. The electronic database allows for information to be extracted in
the form of trend reports, rather than lists, as previously generated.
1.3 In March 2000 the incident reporting and complaints policy was reviewed,
approved and incorporated into the corporate policy manual. Timeframes for
incident management are given in the policy. Staff are required to report
incidents within 24 hours of the event. Some incidents may not require
individual review. These are closed at the time of logging and trend monitored
and reviewed by the Quality and Risk Management Committee (Q&RMC).
Incidents that require individual tracing and review are required to be
forwarded within 24 hours to the appropriate staff member. All reviews are to
be completed within 14 days of notification.
2. EXTERNAL REVIEW
2.1 On 31 August 1999 a review of the Tairawhiti Healthcare incident reporting
system was completed for the Health Funding Authority (HFA). THL stated
that, at that time, it was informed that the review was an information gathering
exercise only, that would lead to the establishment of national best practice
guidelines.
2.2 The main areas where Tairawhiti Healthcare was assessed as not meeting HFA
requirements included:
• Lack of a process for promptly informing senior management/Chief
Executive of serious incidents
• Consumer related issues eg, notification of the consumer, recording his
or her view of the incident and advising the affected consumer of the
findings of an incident investigation
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