Table 2 Comparison of the incident reporting process in GIM and OBS/NEO

Incident detection

Predominantly nurses

Team approach

Predominantly outcome based (falls and medication errors)

Outcome and near miss based

Analysis

Individual nurse leader investigation

Individual nurse leader investigation

Individual physician review to determine preventable harm

Multidisciplinary pre-screen committee review

Larger multidisciplinary QA review for policy type issues

Learning through reporting

Feedback to individual nurses through “teachable moments”

System focus

Ambiguous linkage to incident reports (e.g. M&M rounds)

Clear linkage to incident reports (e.g. Accidental extubation project in NICU)

Feedback

Staff meetings (nursing)

Staff meetings, bi-annual newsletter, occasional reporter participation in QA meeting