Description and outcomes of a custom Web-based patient occurrence reporting system developed for Baylor University Medical Center and other system entities.

PROBLEM To improve the timeliness, efficiency, and effectiveness of occurrence reporting. SETTING Baylor University Medical Center, a 1000-bed tertiary facility, and other components of the Baylor Health Care System, all located in Dallas and the surrounding area. STRATEGIES FOR IMPROVEMENT Designing a custom Web-based patient occurrence reporting system through the efforts of the Center for Quality and Care Coordination and Information Services and training staff not only in using the system but also in viewing reporting as a key element for quality and safety rather than as an individual performance or disciplinary measure. EFFECTS OF CHANGE Both the number of occurrences reported and the timeliness of reports improved: prior to implementation of the Web forms, an average of 128 paper patient occurrence reports were received per month an average of 7.6 days after the occurrence; in the 12 months afterwards, an average of 175 patient occurrence reports were submitted, with 82% reported within 24 hours of the occurrence. Anecdotal comments about the system from end users have been positive. CONCLUSION Paperless Web-based systems are timely, efficient, and effective. The system developed at Baylor met its goals, including being secure, offering online helps and formal education, creating a risk stratification model, remaining adaptable for system needs, and serving as a tool for data analysis. Efforts to change the culture around patient occurrence reporting are ongoing and an essential element for success.