Implications from China patient safety incidents reporting system

OBJECTIVE: We aimed to explain the operational mechanism of China National Patient Safety Incidents Reporting System, analyze patterns and trends of incidents reporting, and discuss the implication of the incidents reporting to improve hospital patient safety. DESIGN: A nationwide, registry-based, observational study design. DATA SOURCE: The database of China National Patient Safety Incidents Reporting System. OUTCOME MEASURES: Outcome measures of this study included the temporal, regional, and hospital distribution of the reports, as well as the incident type, location, parties, and possible reasons for frequently occurring incidents. RESULTS: During 2012–2017, 36,498 patient safety incidents were reported. By analyzing the time trends, we found that there was a significant upward trend on incidents reporting in China. The most common type of incidents was drug-related incidents, followed by nursing-related incidents and surgery-related incidents. The three most frequent locations of incident occurrence were Patient’s Room (65.4%), Ambulatory Care Unit (8.4%), and Intensive Care Unit (7.4%). The majority of the incidents involved nurses (40.7%), followed by physicians (29.5%) and medical technologist (13.6%). About 44.4% of the incidents were attributed to the junior staff (work experience ≤5 years). In addition, incidents triggered by the senior staff (work experience >5 years) were more often associated with severe patient harm. CONCLUSION: To strengthen the incidents reporting system and generate useful evidence through learning from incidents reporting will be important to China’s success in improving the nation’s patient safety status.