The ultimate goal of the system was to encourage and support an environment of safety and reporting along with better process efficiency and standards. Specifically, the Health Region sought to increase the overall number of reports and the proportion of close calls or hazards reported as opposed to adverse events. Far greater participation in reporting from the non-nursing staff population was also encouraged.
After consulting with national and international safety and reporting experts, specific system design criteria were mandated that focused primarily on ease of use and confidentiality.
According to Glenn McRae, Executive Director, Patient Safety, Alberta Health Services, confidentiality was a major hurdle, “When staff recognize an adverse event has occurred a major factor in determining whether staff will choose to submit a report on that event is related to psychological safety – if they fear that submitting the report will result in repercussions against themselves or a colleague they may opt to not report. Allowing staff the option to report in confidence goes a long way in making the system safe to use.
An additional design criterion was to ensure those submitting reports routinely receive information on the role of reporting in making care safer for patients. Therefore, the Clinical Safety Evaluation Office established communication processes to provide feedback to specific reporters and to share information widely when improvements occurred as a result of reporting.
After an extensive evaluation of the marketplace, Datix software, a highly intuitive web-based solution, was chosen as the platform for the new system. One of the key criteria for the selection of Datix was its ease of use and configurability. The flexibility of the Datix system was fundamental to the success of the project. Whereas other vendors were restricted by how much their technology could be tailored, Datix designed the system to meet the business requirements of Alberta Health Services.
The Alberta Health Services configuration of the Datix system was envisioned as a major culture carrier in the Alberta Health Services pursuit of a Safety Culture.
In collaboration with Deloitte, Datix combined expertise in software, implementation and consulting to improve patient safety, quality and risk management practices. This combined approach has brought to bear a high level of implementation experience in healthcare organizations at all levels.
Jonathan Hazan, CEO of Datix said, “Our work with the Alberta Health Services has been so successful that it has been extended across regions, no mean task for an organization that has multiple acute care hospitals, carries out millions of emergency visits and performs hundreds of thousands of operations every year. The project has demonstrated that we are able to help healthcare organizations learn about their processes and practices, while encouraging them to continuously improve. The new system has enhanced the visibility of events at each level across the organization to the benefit of patients and their safety.”
Since moving to the new Datix confidential reporting system, Glenn McRae and his team of patient safety professionals have reaped significant benefits and met their initial targets.
Since March 2008, the overall number of patient safety learning reports submitted has tripled from an average of 1,076 per month to 3,055 per month. The proportion of close calls and hazards reported has also increased, more than double from 10% to 22% using the new Datix system.
The reporting process is now much faster and less complicated. Before Datix, the majority (58.6%) of staff felt it took too long to fill a report with nearly half (48.8%) finding the process too complicated. These figures have improved dramatically, down to 23.9% and 17.4% respectively.
The most significant changes have been in the perception of staff to reporting adverse events, close calls and patient safety hazards more often and more openly. The confidence of staff in the Datix system has grown exponentially, clearly demonstrated by the wider use of the system.
Interestingly, the sharp increase in overall reports submitted matches the growing trust that staff have in the system. Before Datix, 34.9% of staff believed they might be unfairly blamed for an adverse event or safety learning report compared to just 16% after the Datix implementation.
Alberta Health Services brings together 12 formerly separate health entities in the province including three geographically based health authorities, Alberta Alcohol and Drug Abuse Commission (AADAC), Alberta Mental Health Board and Alberta Cancer Board.
They are skilled and dedicated health professionals, support staff, volunteers and physicians who promote wellness and provide health care every day to about 4 million Albertans, as well as to many residents of Saskatchewan, British Columbia and the Northwest Territories.
Alberta Health Services has over 104,000 employees, including about 96,100 direct AHS employees and almost 8,000 staff working in AHS wholly-owned subsidiaries and 17,600 volunteers and almost 8,400 physicians.