title: Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS): relevance and structure.
abstract: BACKGROUND
  In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU) and the European Academy of Chiropractic (EAC) involved in the European Committee for Standardization (CEN) process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of potentially harmful interventions and to facilitate the treatment of patients within the context of achieving maximum benefit with a minimum risk of harm; second, to inform the training objectives for the Graduate Education and Continuing Professional Development programmes of all 19 ECU member nations, regarding knowledge and skills to be acquired for maximising patient safety; and third, to develop a guideline on patient safety incident reporting as it is likely to be part of future CEN standards for ECU member nations.
  
  
  OBJECTIVE
  To introduce patient safety incident reporting within the context of chiropractic practice in Europe and to help individual countries and their national professional associations to develop or improve reporting and learning systems.
  
  
  CONCLUSIONS
  Providing health care of any kind, including the provision of chiropractic treatment, can be a complex and, at times, a risky activity. Safety in healthcare cannot be guaranteed, it can only be improved. One of the most important aspects of any learning and reporting system lies in the appropriate use of the data and information it gathers. Reporting should not just be seen as a vehicle for obtaining information on patient safety issues, but also be utilised as a tool to facilitate learning, advance quality improvement and to ultimately minimise the rate of the occurrence of errors linked to patient care.
  
  
  CONCLUSIONS
  Before a reporting and learning system can be established it has to be clear what the objectives of the system are, what resources will be required and whether the implementing organisation has the capacity to operate the system to its full advantage. Responding to adverse event reports requires the availability of experts to analyse the incidents and to provide feedback in a timely fashion. A comprehensive strategy for national implementation must be in place including, but not limited to, presentations at national meetings, the provision of written information to all practitioners and the running of workshops, so that all stakeholders fully understand the purposes of adverse event reporting. Unless this is achieved, any system runs the risk of failure, or at the very least, limited usefulness.
authors: European Academy of Chiropractic, academic dean and private practice, Bahnhofstrasse 15, 3400 Burgdorf, Switzerland.
authors: Martin
authors: M
authors: Wangler
authors: Real Centro Universitario Maria Cristina-College of Chiropractic, Paseo de los Alamillos 2, 28200 San Lorenzo de El Escorial, Spain.
authors: Ricardo
authors: R
authors: Fujikawa
authors: Nordisk Institut for Kiropraktik og Klinisk Biomekanik Forskerparken 10, 5230 Odense M, Denmark.
authors: Lise
authors: L
authors: Hestbæk
authors: European Academy of Chiropractic, Department of Research and private practice, St. Paulusstraat 15, 2400 Mol-Belgium.
authors: Tom
authors: T
authors: Michielsen
authors: European Council on Chiropractic Education and private practice, Kiropraktorklinikken Strandgården, Havnegt. 1, 4790 Lillesand, Norway.
authors: Timothy J
authors: TJ
authors: Raven
authors: Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth BH5 2DF, UK.
authors: Haymo W
authors: HW
authors: Thiel
authors: Swiss Academy of Chiropractic and private practice, Johann-Verresius-Str. 18 2502 Biel, Switzerland.
authors: Beatrice
authors: B
authors: Zaugg