Department of Human Services Incident Reporting Instruction 2010

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Incident Reporting Instruction – Technical Update

Focus of today’s session

The purpose of today’s session is to:

• Overview of technical update Nov 2010

• Incident reporting – what it is and why we do it.

• Provide an overview of the incident reporting requirements, including when an incident report is required.

• Explain incident types and categories.

• Demonstrate how to complete the incident report form.

• Illustrate how we can learn and improve our service delivery through good incident reporting and analysis.

2010 Technical Update :

• Reporting requirements remain the same – minor amendments only

• Clarification of Scope

– Individualised Support Packages

• Shared Clients

• Enhanced Incident report form

The benefit of incident reporting

Incident reporting is part of quality improvement and safety.

The key reason for reporting incidents is to learn from them and if possible, prevent their repetition

.

Without a detailed analysis of incidents and near misses, we may fail to uncover problems that are potential hazards to clients and staff.

Who is in scope for the IR instruction?

Program

Child Protection

Disability Services & Respite care for client with disability

Out of Home Care (CYF)

Youth Justice Community Supervision

Youth Justice Custodial Services

Housing & Community Building

Family Services

Child FIRST

X

X

X

1

X

X

X

X

X

Category

2

X

X

X

X

X

X

3

X

X

X

X

X

Disability Services individually attached and portable funding packages

Disability service providers as defined under the Disability Act, where it is known that a client has purchased a service using an individualised support package (ISP) or other disability support services, must comply with all aspects of the incident reporting instruction.

When is an incident report required?

Incident reports are required for incidents that involve and/or impact upon clients that occur at the service or during service delivery.

During Service Delivery

Two types of clients

Clients receiving 24 hour care

• all child protection clients

• Persons residing in departmental; or CSO residential or custodial services

Incident reports required for all incidents irrespective of location

Clients receiving episodic care

• all other clients

Incident reports are required for all incident occurring at service or during service delivery.

Shared Clients

– The program or CSO that first becomes aware of incident is responsible to complete the incident form unless a more appropriate program or

CSO takes responsibility for completing the form.

– The form is to be submitted to the geographic region of the reporting service.

– The region is responsible to record the incident report in TRIM.

– The region must ensure programs or CSO that have responsibility or involvement with the client are informed.

Incident Types and Categories

A descriptor or incident type is selected for each incident.

Incidents are graded or categorised according to the actual impact or the potential risk

Category One

Category Two

Category Three

Most serious outcome

Serious threat to well being of clients and staff

Local impact

Category One incidents

These are the most serious incidents.

All Category One incidents must be reported within one working day.

Category One incidents

Examples include:

• The death of, or serious injury to, a client or staff member

• Allegations of, or actual, serious sexual or physical assault of a client

(such as rape, assaults with a weapon, assaults resulting in hospitalisation)

• All assaults of a client by a staff member or volunteer carer regardless of injury or type of assault

• Sudden illness resulting in hospitalisation

• An incident that has the potential to involve high levels of public or legal scrutiny.

Category Two incidents

Events that seriously threaten clients or staff.

Examples include:

• Incidents that did not lead to significant client or staff injury or death, but very nearly did (near misses).

• Sudden deterioration of a known medical condition

• Client behaviour that could result in potential risk to clients or others

Must be reported as soon as possible, at the latest within two working days.

Category Three incidents

Normal work and routine is interrupted, but the significance of the incident does not extend beyond the workplace or facility.

Examples include:

• Minor property damage

• Injury not requiring medical attention

• Shoving, pushing between clients that doesn’t cause harm

Frequently Recurring Behaviours

‘Frequent behaviour’ is reportable behaviour of the same incident type and subtype by a client that occurs more than once in a shift or workday.

For example incident type ‘behaviour' and subtype ‘verbal abuse’.

For Category Two and Three incidents where a behaviour is clearly identified in a client care plan or support plan and occurs multiple times in a single work day or shift the incidents may be summarised in one incident report.

•Separate incident reports for each occurrence are not required.

•The incident report must clearly describe the number of episodes of the behaviour outlined.

Immediate response and reporting requirements

Respond to immediate safety concerns

Take remedial action to re-establish a safe environment

Most senior staff member reports using IR form

Allegations of physical and sexual assault for some clients must be reported to Police

The manager, CEO or supervisor records response to the incident and action taken to prevent recurrence

Category One

Must be reported within one working day

Category Two

Must be reported within two working days

Category Three

Must be reported within two working days

Completing an incident report form

• Incident report form - electronic or printable version *

• How to Complete an Incident Report Form

• Writing Effective Incident Reports

• Only send one incident report per fax

Example scenarios

Example A

A client’s health deteriorated and he was hospitalised on Monday 1

November 2010. A phone call was received by the residential service at 6.55pm from the hospital to advise the client had died.

Example B

On 5 October at approximately 10.30am an out of home care client discloses to you that she had been hit by her carer resulting in bruising.

Organisational Learning

Incidents must be reviewed to learn from events and improve future service quality and safety.

Region to insert slide on regional data analysis.

Eg: pie chart , graph

More information?

Contact your supervisor, team leader, manager or IR co-ordinator

Websites:

Funded Agency Channel www.fac.dhs.vic.gov.au

KnowledgeNet (DHS staff only) www.knowledgenet.csv.au

SDP IR Help Desk Andrea Grant 9096 0283

Louise Crowther 9096 5704

Summary

• There has been a technical update of the Departmental Incident

Reporting Instruction. The reporting requirements remain the same.

• Incident reporting is part of quality improvement and safety.

• The key reason for reporting incidents is to learn from them and if possible, prevent their repetition.

• Incident reports are required for all incidents that involve or impact upon clients that occur during service delivery.

• A descriptor or incident type is selected for each incident.

• Incidents are graded or categorised according to the actual impact or the potential risk.

• Incidents must be reviewed to learn from events and improve future service quality and safety.

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