In 2001, British Columbia Health Services modernized a complicated healthcare system by merging 52 health authorities into a streamlined governance and management model.
Today, there are six health authorities in total: one Provincial Health Services Authority provides centralized programs and specialized services such as cardiac care and transplants and a further five health authorities govern, plan and co-ordinate services at a regional level.
The drive towards streamlining processes and delivering greater efficiency of patient care and services has been replicated at all levels of the organization including the use of technology to underpin the new infrastructure. For example, early in 2004, a feasibility study highlighted the requirement for a comprehensive patient safety incident reporting system for healthcare across the province.
The study followed a provincial Risk Management Committee recommendation to explore the possibility of implementing a province-wide, electronic incident reporting information solution to replace multiple existing paper-based systems in order to collect information quickly, enable timely notification to leaders and facilitate a more standardized approach to reporting patient safety events. In 2005, following an in-depth competitive selection process, Datix was selected for this reporting system.
"This has been a truly collaborative provincial effort. Our implementation approach has helped foster a safety culture based on a more consistent, just and transparent reporting and learning environment."
Annemarie Taylor, Provincial Director at British Columbia Patient Safety Learning System
Standardized approach supports new business model
Important to British Columbia (BC) was a streamlined process and a standardized approach to the reporting of adverse events. The process needed to bring data together at both the health authority and provincial levels and enable the collective sharing of lessons learned. In 2007, two pilot sites were chosen, a Neonatal Intensive Care Unit with over 300 users and a Vascular & General Surgery with more than 100 users. Building on the successful pilots the first Datix system went live in February 2008.
Annemarie Taylor, Provincial Director, British Columbia Patient Safety & Learning System, estimates that approximately 60,000 healthcare providers across BC can currently report safety events using the Datix system. Once fully implemented, that number will grow to between 75,000 and 100,000. Approximiately 10% of that number are authenticated Datix users trained for follow-up or further investigation of individual incidents.
Patient safety - software of choice
In addition to choosing Datix software as the platform for the new system, the British Columbia Health Authorities called on Deloitte, Datix’s strategic alliance partner in Canada, to help with project management, process definition, system configuration, testing and organizational change management.
Dealing effectively with adverse events, claims and complaints
Jonathan Hazan, CEO of Datix commented, “The objective of the project was to bring about a change in culture as well as implementing the reporting system. To achieve this, the process had to be tailored to the individual people, resources and culture of each health authority. The one-size fits all approach simply wasn’t an option. Three modules were originally implemented and these were Incident Reporting, Claims Management and Complaints Management.”
Positive results from one of the initial pilot projects showed over a 150% increase in the number of reports and that these reports came from a wider distribution of staff. These findings demonstrate that the system was well-accepted by reporters, and good adoption by these users has remained consistent throughout provincial implementation.
According to Ms Taylor, “We now have over 100,000 incidents on our database, logged since our first Go Live in February 2008. Importantly, using mandatory fields ensures that we have 100% completion of the most important fields. We are finding that the vast majority of reports are submitted within 24 hours of the event, and managers in clinical areas are notified immediately.”
One of the biggest challenges was changing the way people responded to reported incidents. Ms Taylor said, “With a paper system, the manager could scan a report, put it aside if it was not a critical issue and then get to the batch of reports when it was convenient. With the electronic system, action can and ideally should be more immediate. The manager can respond while the information is current and people involved are available for follow-up and issues can be quickly addressed. The system keeps each report at the forefront, allows several people to see a report concurrently and provides information about timeliness of the event management process.”
Patient safety & learning: a role model for the rest of the organization
The implementation of Datix has been so successful that there are plans under consideration to expand the use of the Datix system to other parts of the British Columbia healthcare organization, especially where there is a need to collect and share information about specific patient groups or activities.
For example, one group that works with adult victims of neglect is piloting the use of the system to track incidents relating to elder abuse. Another team conducting research involving parents of sick children in hospital is using the system to collect the parents’ observations about patient safety events and near misses such as administering the wrong medication. The provincial ambulance service will also be starting to use a tailored version of Datix to report patient safety events that occur out in the field or when a patient is brought into the emergency room.
- Following worldwide search Datix selected for patient safety analysis and reporting
- Requirement for more events to be reported and for greater visibility
- Pilot project showed 150% increase in number of reports
- Approximately 100,000 healthcare providers across BC can currently report safety events using Datix
- Resulted in greater efficiency in reporting and follow-up
- Datix and Deloitte in Canada combined expertise in software, implementation processes and consulting to improve patient safety, quality and risk management practices
- Datix has helped BCHA meet legislation passed in the province around monitoring and responding to complaints
- Ambitious plans are in place to build robust aggregate reports to drive system change