Going paperless with custom-built Web-based patient occurrence reporting.

BACKGROUND: Baylor University Medical Center (Dallas) converted patient occurrence reporting from a paper form to a custom-built Web-based system that used the medical center's intranet. DEVELOPING THE WEB-BASED SYSTEM: Non-medication patient occurrences were documented manually on paper forms known as incident reports, and medication variances were entered electronically. The medical center had used the same paper form for many years, without any interim updates or revisions. With a delay of more than a week in receiving forms, the process was not efficient or timely. In addition, paper forms were sometimes illegible or incomplete. LAUNCHING THE PROJECT: The project team, representing the Center for Quality and Care Coordination and information services, decided that the best approach would be a phased implementation based on development of system functionality and a facility's readiness for conversion. Reporting was to be conducted in terms of 10 standardized patient occurrence reporting categories. RESULTS AND EVALUATION: Comparison of quarterly data pre- and post-Web forms showed an 83.5% increase in number of submissions and a 79.5% reduction in event-to-submission time. Web forms also eliminated paper form limitations of legibility, completeness, and security.
CONCLUSION: It is still an individual responsibility to report and then transform collected data into usable information, which will drive process improvement. Technology can make an important contribution to these efforts, but the culture of the organization must have a complete program strategy. The focus must shift to reporting as a cornerstone to quality and safety and away from traditional notions of error and blame.