Session 3 - Incident Reporting Policy - Health Partnerships Learning ...

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Appendix B Risk Grading Matrix Severity LIKELIHOOD 1 Insignificant 2 Minor 3 Moderate 4 Major 5 Catastrophic 1 - Rare 2 - Unlikely 3 - Possible 4 - Likely 5 - Almost Certain 1 2 3 4 5 2 4 6 8 10 3 6 9 12 15 4 8 12 16 20 5 10 15 20 25 Risk High (H) Moderate (M) Low (L) Further Action Risk Priority Significant Risk. As below plus: Report to Managing Board identifying treatment options Quarterly report to the Managing Board monitoring progress on treatment action plans Unacceptable Risk. As below plus: (12 and above) Report to the Governance Committee identifying treatment options (12 and above) report to the Q&RSC monitoring progress on treatment action plans Acceptable Risk. As below plus: discuss whether any further action should be taken to reduce future risk By Whom Governance Committee Q&RSC Team Meetings Risk Matrix – Likelihood Likelihood rating Description 5 Almost Certain this type of event will happen frequently 4 Likely this type of event will happen, but its not a persistent concern 3 Possible this type of event may well happen (e.g. 50/50 chance) 2 Unlikely unlikely that this type of event will happen 1 Rare cannot believe that an event of this type will occur in the foreseeable future Page 20 of 28
Risk Matrix – Severity 1 2 3 4 5 Descriptor Insignificant Minor Moderate Major Catastrophic Over three days off Major injuries, or Injury Minor injury or “sick” = RIDDOR long term Death or major Minor injury not illness, first aid reportable. 10 days incapacity / permanent requiring first aid treatment needed to report to the disability (loss of incapacity HSE. limb) Patient Experience Unsatisfactory patient experience not directly related to patient care Unsatisfactory patient experience - readily resolvable Mismanagement of patient care – short term effects Mismanagement of patient care – long term effects Totally unsatisfactory patient outcome or experience Complaint/ Claim Potential Locally resolved complaint Justified complaint peripheral to clinical care Justified complaint involving lack of appropriate care Multiple justified complaints Multiple claims or single major claim Objectives/ Projects Service/ Business Interruption Human Resources/ Organisational Development Insignificant cost increase/schedule slippage. Barely noticeable reduction in scope or quality Loss/interruption > 1 hour Short term low staffing level temporarily reduces service quality (< 1 day) < 5% over budget/schedule slippage. Minor reduction in quality/scope Loss/interruption > 8 hours Ongoing low staffing level reduces service quality 5 -10% over budget/schedule slippage. Reduction in scope or quality requiring client approval Loss/interruption > 1 day Late delivery of key objective/service due to lack of staff (recruitment, retention or sickness). Minor error due to insufficient training. Ongoing unsafe staffing level 10 - 25% over budget/schedule slippage. Doesn't meet secondary objectives Loss/interruption > 1 week Uncertain delivery of key objective/ service due to lack of staff. Serious error due to insufficient training > 25% over budget/schedule slippage. Doesn't meet primary objectives Permanent loss of service or facility Non-delivery of key objective/ service due to lack of staff. Loss of key staff. Very high turnover. Critical error due to insufficient training Financial Small loss (> £100) Loss > £1,000 Loss > £10,000 Loss > £100,000 Loss > £1,000,000 Inspection/ Audit Adverse Publicity/ Reputation Minor recommendations. Minor noncompliance with standards Rumours Recommendations given. Noncompliance with standards Local Media - short term Reduced rating. Challenging recommendations. Non-compliance with core standards Local Media - long term Enforcement Action. Low rating. Critical report. Multiple challenging recommendations. Major noncompliance with core standards National Media < 3 Days Prosecution. Zero Rating. Severely critical report National Media > 3 Days. MP Concern (Questions in House) Page 21 of 28
Page 1 and 2: Incident Reporting Policy Reader in
Page 3 and 4: 1 Introduction The effective report
Page 5 and 6: Other incidents: Some incidents may
Page 7 and 8: Ensure that risk assessments are re
Page 9 and 10: Following a reported incident, rega
Page 11 and 12: Incident Reporting Folders (a compl
Page 13 and 14: All Action Plans relating to incide
Page 15 and 16: Department of Health. (2000). An Or
Page 17 and 18: Guidance on completing an Incident
Page 19: SECTION 10 (S10) PART 2 IS TO BE CO
Page 23 and 24: Appendix D DEFINITIONS OF SERIOUS U
Page 25 and 26: Appendix E SENIOR MANAGER ON-CALL A
Page 27 and 28: Appendix G Plan for Dissemination o

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