I was talking to a prospective client recently—a Director of Nursing for a Skilled Nursing Facility with about 130 residents. I was trying to get a feel for how they work and whether or not QA Reader would be a good fit for them.
I asked my normal questions: how many residents, how do they currently report incidents (paper or in an electronic health record), how do they keep track of incidents, frequent fallers, potentially serious events, etc. As we were talking, the DON suddenly blurted out, “Incident reports are a waste of time!”
I was stunned. How could she possibly say that? Incident reports provide valuable information. I mean, they must, otherwise why on earth would a typical, 100-bed community, fill out an average of one incident report per day?
So I asked her to explain what she meant by that. She described the process at length. I’ve since had the chance ask a few other DONs, QA managers, and administrators about their experiences and I now understand better what the basic frustration is.
Incident Reports Are Disruptive
Incident reports document events that are unusual or disruptive for a resident or community. They can document anything from an unexplained bruise to an injury resulting in death. The intention is to provide an objective account of the incident and to get information that can help improve the quality of care at the individual resident level and at the senior care facility overall.
There are guidelines and protocols and procedures for when and how to fill them out and what happens to them after that—and while there may be agreed-upon best practices, there is no standard approach across the industry.
Lifecycle of an Incident Report
So let’s go through the lifecycle of a fairly common type of incident report—a fall with a fracture that sends the resident to the hospital. There is most likely other paperwork that needs to be completed—medical record updates, CMS data entry, communication with family members, doctors, care plan updates, etc.—but that's in addition to the incident report.
The nurse completes the incident report, which begins the interdisciplinary process of review and notification. Ultimately, the QA committee receives the report and begins the process of root cause analysis and trending/tracking.
Since this was a fall, either the DON or the QA Manager opens and updates two (or sometimes three) spreadsheets on their computer—the incident log, the fall log, and possibly the serious events log. Each of these logs needs to be maintained and it’s usually just one person who's in charge of making sure it gets done and that it's accurate. But sometimes more than one person does the updating.
SNF administrators say that there are inconsistent methods for using and updating the spreadsheets, and that sometimes they're out of date. At some point, this incident will get reviewed by the Falls/Safety Committee or the QA Committee, and the DON needs to have their spreadsheets generated. Then they're ready to have the important discussion about what happened, what factors were involved, and what changes or improvements may be in order.
That last piece is what the DON really cares about—how to make things better and prevent future occurrences.
One client was able to reduce incidents and administrative nursing hours with QA Reader—you can read their story here.
Incident Reports Are Wasting Your Time
Multiply that process by the number of incidents per week. Think about the human time involved with doing the data entry and upkeep that could be done more easily and more efficiently by a piece of incident management software. Consider how a person who went into a caring profession like nursing feels when they spend hours every week doing basic data entry instead of creating and implementing new interventions and innovative staff training. That’s why my DON friend said that incident reports are a waste of time.
It is a waste of her extensive professional training and skill to perform a repetitive task that is damaging to her morale. Incident management software is more efficient, accurate, and faster than a human being when it comes to data. And incident management software won’t complain about compiling elegant, easy-to-read and easy-to-use incident reports that identify weak spots needing attention.
QA Reader is designed to end that wasted time and get your nursing staff back to their real work, their mission: caring for residents.
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