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Melden van incidenten in de GGZ

Troost, M. (2009) Melden van incidenten in de GGZ.

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Abstract:Background: Information that plays an important role in improving the quality and safety of care, will become available by reporting incidents. Although the reporting of incidents in healthcare has been in the picture for a couple of years, only a very small part of the incidents that take place are reported. At Dimence, it is also expected that a lot of the incidents that take place are not reported. Several investigations, outside of Dimence, have been done to discover reasons for not reporting incidents. Although a lot of potential reasons are summed in the literature for not reporting incidents, there is only little empirical evidence of what the real reasons are. Methods: 114 teams are part of the primary process of Dimence. By means of a stratified sample, on the basis of the number of incident reports that were done in 2008 at team level, forty teams are selected to take part in the investigation. Every member of the selected teams is handed a questionnaire. In which questions are asked to discover how many incidents employees have faced in the last three months and how many of these incidents they have reported. Questions are also asked to discover the intention, the attitude, the subjective norm and the self-efficacy of the employees concerning the reporting of incidents and to discover the team cohesion and the safety culture. Of the 609 spread questionnaires, a total of 274 returned questionnaires were used in the analyses. Results: The 274 respondents experienced at least 3826 incidents in the last three months. Frequently experienced incidents are insults by a client and clients that do not comply to appointments. Incidents that rarely take place are wrong attached fixations and needle incidents. At most, only 6% of the incidents are reported by filling out an incident report form and the reports are done by 29% of the respondents. The attitude, the subjective norm, the self-efficacy and the safety culture explained the variance in the intention for 28%, for the group with teams which filled out more than 15 incident report forms in 2008. Discussion: This investigation showed that, at this moment, the attitude, the subjective norm, the self-efficacy and the safety culture offer a reasonable explanation for the variance in the intention and the reporting of incidents at Dimence, for the group with teams that filled out more than 15 incident report forms in 2008. A reason for the limited explanation at the other groups is the inexperience of the employees with the reporting of incidents. At the group that has the knowledge about how to report incidents, the explanation was a lot better. By raising the scores on the attitude, the subjective norm, the self-efficacy and the safety culture, the number of incident reports will increase. Conclusion: The attitude, the subjective norm, the self-efficacy and the safety culture influence the decision to report incidents. Reasons of Dimence-employees for not reporting incidents are the neutral attitude about reporting incidents, the limited social pressure they feel for reporting, the unfamiliarity about which incidents should en shouldn’t be reported and the unfamiliarity about which form has to be used for which incident. The absence of a safety culture is also of influence. Recommendations: To increase the number of incident reports, the social pressure of the Board of Directors and the supervisors on the employees should be raised. Furthermore, employees need to be informed about the incidents to report and the organisation should develop a form which can be used to report all types of incidents. Since it doesn’t seem clever to make a report of every incident that takes places, because of the large number of incidents, the definition for incidents that have to be reported could be focussed on avoidable incidents. Another option is to make only one report for incidents that take place very frequently. This way not every time the incident takes place a reporting form has to be filled, but in the end it is clear how often the incident took place.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
Link to this item:http://purl.utwente.nl/essays/59622
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