1. CBI Incident Reporting System Caroline Gill PT MHM Betty Wills RN PhD CHCA 2014

2. Objectives What is the CBI Incident Reporting tool Why develop it Who will use it When are notifications sent Where are we at with the project How is it valuable in the current environment 2

3. CHCA 2014 Acknowledgements Executive Leadership Team Senior Leadership Team Project Team Pilot locations Early adopters! 3

4. CHCA 2014 Who are we? CBI Health Group is a values-based, results- oriented and collaborative company that provides more access and better health outcomes to patients and communities across Canada. CBI Home Health/We Care, the Home Health division of CBI Health Group with locations nationally; our focus today is on Alberta and Ontario. 4

5. CHCA 2014 Alberta and Ontario Home Health Network 5 In Alberta: Personal Support Services and Nursing in 5 locations In Ontario: Personal Support Services, Nursing, and Therapy Services in 21 locations (13/14 CCACs) Approx. 7500 clinical and 375 administrative personnel across Alberta and Ontario

6. CHCA 2014 Patient Safety in Home Care 6 Can incident reporting improve safety? Healthcare practitioners' views of the effectiveness of incident reporting (2013, Anderson et al) Anderson et al, International Journal for Quality in Health Care 2013; 25(2) 141-150 Addressing safety in home care and mitigating the risks presents unique challenges and requires a major rethink of underlying institutionally oriented assumptions and guiding frameworks. (2008,Lang et al) Lange et al, International Journal for Quality in Health Care 2008 ; 20(2): 130-5. Epub2007 Dec 23. Roadmap for Safety at Home ( 2013, Hennigan) Rehab and Community Care Medicine 2013,22(4) http://publications.rehabmagazine.ca/publication/?i=189873

7. CHCA 2014 What is CBI’s IR Tool IR Tool is CBI’s electronic incident management system IR Tool is more than a reporting tool Designed to be used within CBI Home Health and will be deployed to all CBI divisions It captures, tracks and trends all events that pose a risk to patient, personnel and organization It meets internal and external reporting needs 7

8. CHCA 2014 Main features of IR Tool Themes/sub themes – Categories for incidents Distribution groups – Notification groups Data points – Data collected for each type of sub theme Notifications – To distribution group/reporter 8

9. CHCA 2014 IR Tool is more than just a repository! Dynamic tool that captures all risk incidents and compliments Allows visibility to CBI leadership and ensures integrity of reporting (e.g. audit trail) Enhances accountability of reporting, investigation, documentation and closure of incidents Minimizes multiple emails, voice mails, and scribbled notes 9

10. CHCA 2014 Who uses it? All personnel (admin +/- regulated frontline) can access the online tool Incidents are auto-escalated internally to the appropriate and designated individuals in a timely way Managers have ultimate responsibility for oversight (i.e. ensure completeness of reporting, investigation, and documentation prior to closing the incident) 10

11. CHCA 2014 Incident Escalation: Themes & Distribution Groups Incident Report Theme Sub Theme Distribution Group 11 The reporter must select the theme and sub theme when reporting an incident Each sub theme is associated to a specific distribution group. The distribution group is automatically informed of the reported incident Each sub theme has a specific data set or set of questions

12. CHCA 2014 Themes and Distribution Groups Example

13. CHCA 2014 Distribution Groups 13 Roles Included Distribution Group Privacy Distribution Group Chief Privacy Officer Director of Quality and Risk Regional Privacy Officer Director of Operations Local Manager Code of Conduct Distribution Group Local Manager Human Resources Manager Local Incident Reporting Distribution Group Local Manager Director Escalated Incident Reporting Distribution Group Lawyer Director of Quality and Risk Local Manager Director of Operations Supervisory Distribution Group Local Manager WSIB Distribution Group Human Resources Manager Local Manager

14. CHCA 2014 14

15. CHCA 2014 Notification 15

16. CHCA 2014 When are notifications shared? Daily notifications will be sent to each user that has an issue assigned to them Weekly notifications will be sent to each member of a distribution group Notifications of active (‘open’) incidents will be sent to those involved as a reminder that follow up is required Personnel have access to their Dashboard for ease of incident management 16

17. CHCA 2014 17

18. CHCA 2014 Where are we at? Project Development 18 DesignDevelopmentPilot Modify based on feedback from pilot Live AB Oct 1, 2014 Live ON Nov 30, 2014 Maintenance Collect feedback after going live

19. CHCA 2014 Are we there yet? Clinical and IT personnel (Ontario and Alberta) made up the Project Development Group Piloted in sites in Ontario and Alberta Tool modified following pilot site feedback Champions to provide support to each site as needed Training sessions (via webinar and online resources) completed in September 2014 Live in Alberta Home Health since Oct 1, 2014 Planned Go Live in Ontario Home Health by Nov 30, 2014 19

20. CHCA 2014 Reports to Funder Many different reporting formats to the different funders IR allows data to be downloaded/exported but depending on funder requirements some manipulation of the reports is required CBI’s Central Business Office generates local and provincial reports quarterly 20

21. CHCA 2014 How is it useful…. Initial feedback is positive and consistent: 21 Immediate notification when incident is entered, knowing all who need to know are alerted Flow of reporting/comments etc is easily visible Increased visibility for all Potential for improved quarterly reporting

22. CHCA 2014 Challenges Timely reporting (mobile workforce) Complexity of the home care environment (patient/family/service provider) Ownership and accountability (reporting, follow through, disclosure) Track and trend across multiple locations and provinces (implement preventative measures, enhance education) 22

23. CHCA 2014 Summary 23 Ensures that all reported incidents are escalated appropriately Provides visibility & accountability to incident management Provides ability to report on incident trends Standard tool for all divisions, not just Home Health Mobile friendly; tool is accessible via smart phone

24. CHCA 2014 Questions 24

25. CHCA 2014