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Using a Second Stakeholder-Driven Variance Reporting System Improves Pediatric Perioperative Safety.

Akemi L Kawaguchi1,2, Ranu Jain2,3, Nutan B Hebballi1

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|November 21, 2019
PubMed
Summary

A handwritten variance reporting system significantly increased the identification of patient safety issues compared to a computerized system alone. This quality improvement initiative captured over 1,300 additional variances, highlighting critical local and system problems.

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Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety Reporting Systems

Background:

  • Established computerized variance programs often exhibit low reporting rates.
  • A need exists for more effective methods to capture patient safety events and process issues in perioperative settings.

Purpose of the Study:

  • To compare the effectiveness of a handwritten variance reporting system against an established computerized system in a pediatric perioperative setting.
  • To assess the types and frequency of variances captured by each reporting method.

Main Methods:

  • A stakeholder-driven, handwritten variance reporting system was developed and implemented.
  • Variances were collected from both handwritten cards and the existing computerized system over six years.
  • Data were analyzed and categorized into safety domains and variance types.

Main Results:

  • A total of 3,434 variances were reported, with 2,747 from the handwritten system and 687 from the computerized system.
  • The handwritten system identified significantly more safety process and non-safety issues, while the computerized system captured more adverse events and near-misses.
  • Over 1,300 additional variances were reported via the handwritten system that were not captured by the computerized system alone.

Conclusions:

  • A handwritten, stakeholder-driven variance reporting system is crucial for identifying issues missed by computerized systems.
  • This approach enhances the comprehensive understanding of local and system-wide safety concerns in healthcare.