An integrated framework for safety, quality and risk management: an information and incident management system based on a universal patient safety classification
Open accessAbstract
More needs to be done to improve safety and quality and to manage risks in health care. Existing processes are fragmented and there is no single comprehensive source of information about what goes wrong. An integrated framework for the management of safety, quality and risk is needed, with an information and incident management system based on a universal patient safety classification. The World Alliance for Patient Safety provides a platform for the development of a coherent approach; 43 desirable attributes for such an approach are discussed. An example of an incident management and information system serving a patient safety classification is presented, with a brief account of how and where it is currently used. Any such system is valueless unless it improves safety and quality. Quadruple-loop learning (personal, local, national and international) is proposed with examples of how an exemplar system has been successfully used at the various levels. There is currently an opportunity to “get it right” by international cooperation via the World Health Organization to develop an integrated framework incorporating systems that can accommodate information from all sources, manage and monitor things that go wrong, and allow the worldwide sharing of information and the dissemination of tools for the implementation of strategies which have been shown to work.
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Existing classifications, including AIMS and the ICPS, fall short with respect to computer-related incidents because this source of risk has not been systematically examined.
“However, existing classifications, including AIMS and the ICPS, 18 fall short with respect to computer-related incidents as this source of risk has yet to be systematically examined.20”
From An analysis of computer-related patient safety incidents to inform the development of a classification (2010) · cites this paper as [18]
The Advanced Incident Management System (AIMS) is an incident reporting system based on 20 years of patient safety research, in use since 1998 in more than 1000 facilities across Australia, New Zealand, South Africa, and the United States.
“The Advanced Incident Management System (AIMS) 18 is one such incident reporting system, based on 20 years of research in patient safety, and has been in use since 1998 in more than 1000 facilities in Australia, New Zealand, South Africa, and the United States.”
From An analysis of computer-related patient safety incidents to inform the development of a classification (2010) · cites this paper as [18]
Identifying the natural categories of safety incidents has been the method used for creating the AIMS classification, which is the starting point for expanding the ICPS.
“Identifying the natural categories of safety incidents has been the method used for creating the AIMS classification, which is the starting point for expanding the ICPS.18 30”
From An analysis of computer-related patient safety incidents to inform the development of a classification (2010) · cites this paper as [18]
Incident reports provided by healthcare professionals have been shown to be useful in examining the risks and harm caused by healthcare.
“Incident reports provided by healthcare professionals have been shown to be useful in examining the risks and harm caused by healthcare (eg, falls, medication errors, therapeutic devices, and equipment).18 19”
From An analysis of computer-related patient safety incidents to inform the development of a classification (2010) · cites this paper as [18]
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- Authors
- Runciman, W. B., Williamson, J. A. H., Deakin, A., Benveniste, K. A., Bannon, K., & Hibbert, P. D.
- Affiliations
- Royal Adelaide Hospital (AU)
- Corresponding author
- Runciman, W B
- Venue
- Quality in Health Care
- Publisher
- BMJ
- Published
- 2006-12
- Volume
- 15
- Issue
- suppl 1
- Pages
- i82-i90
- ISSN
- 1475-3898 (ISSN-L)
- 1475-3901
- PMC
- PMC2464872
- OpenAlex
- W2068569336
- Cited by
- 156
- References
- 49
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 9 · 2023: 6 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 6 · 2018: 10 · 2017: 9 · 2016: 10 · 2015: 11 · 2014: 12 · 2013: 13 · 2012: 3
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ Quality & Safety (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- patient safety, quality of care, risk management, incident management system, World Alliance for Patient Safety, safety culture, international cooperation, health information systems, learning from adverse events
- MeSH terms
- Australia, Humans, International Cooperation, Management Information Systems, Medical Informatics, Safety, World Health Organization, Total Quality Management, Safety Management, Systems Integration, Delivery of Health Care, Integrated, Medical Errors
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