title: Evaluation of an intervention aimed at improving voluntary incident reporting in hospitals.
abstract: OBJECTIVE
  To assess the effectiveness of an intervention package comprising intense education, a range of reporting options, changes in report management and enhanced feedback, in order to improve incident-reporting rates and change the types of incidents reported.
  
  
  METHODS
  Non-equivalent group controlled clinical trial involving medical and nursing staff working in 10 intervention and 10 control units in four major cities and two regional hospitals in South Australia.
  
  
  METHODS
  Comparison of reporting rates by type of unit, profession, location of hospital, type of incident reported and reporting mechanism between baseline and study periods in control and intervention units.
  
  
  RESULTS
  The intervention resulted in significant improvement in reporting in inpatient areas (additional 60.3 reports/10,000 occupied bed days (OBDs); 95% CI 23.8 to 96.8, p<0.001) and in emergency departments (EDs) (additional 39.5 reports/10,000 ED attendances; 95% CI 17.0 to 62.0, p<0.001). More reports were generated (a) by doctors in EDs (additional 9.5 reports/10,000 ED attendances; 95% CI 2.2 to 16.8, p = 0.001); (b) by nurses in inpatient areas (additional 59.0 reports/10,000 OBDs; 95% CI 23.9 to 94.1, p<0.001) and (c) anonymously (additional 20.2 reports/10,000 OBDs and ED attendances combined; 95% CI 12.6 to 27.8, p<0.001). Compared with control units, the study resulted in more documentation, clinical management and aggression-related incidents in intervention units. In intervention units, more reports were submitted on one-page forms than via the call centre (1005 vs 264 reports, respectively).
  
  
  CONCLUSIONS
  A greater variety and number of incidents were reported by the intervention units during the study, with improved reporting by doctors from a low baseline. However, there was considerable heterogeneity between reporting rates in different types of units.
authors.affiliation: Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia. sue.evans@med.monash.edu.au
authors.forename: Sue M
authors.initials: SM
authors.lastname: Evans
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Smith
authors.forename: Adrian
authors.initials: A
authors.lastname: Esterman
authors.forename: William B
authors.initials: WB
authors.lastname: Runciman
authors.forename: Guy
authors.initials: G
authors.lastname: Maddern
authors.forename: Karen
authors.initials: K
authors.lastname: Stead
authors.forename: Pam
authors.initials: P
authors.lastname: Selim
authors.forename: Jane
authors.initials: J
authors.lastname: O'Shaughnessy
authors.forename: Sandy
authors.initials: S
authors.lastname: Muecke
authors.forename: Sue
authors.initials: S
authors.lastname: Jones
mesh_terms: D000328:Adult; D030881:Disclosure; D005246:Feedback; D005260:Female; D006757:Hospital Units / Q000145:classification / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D007318:Inservice Training / Q000458:organization & administration* / Q000592:standards; D008297:Male; D019300:Medical Errors / Q000145:classification / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000193:education*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000193:education*; D015397:Program Evaluation; D012308:Risk Management / Q000458:organization & administration / Q000706:statistics & numerical data*; D013021:South Australia / Q000453:epidemiology