After two years of use of the RL6:Risk module, reporting rates at Duke University Health System were steady and aggregate reports were being used mostly by Patient Safety to report trends and patterns. Consistent review of the various General Event Type outputs was not reliable across all clinical divisions of the organization (Clinical Service Units/CSUs). Further, feedback to frontline reporters about data captured by the module was limited. In response, the leadership team launched a task force to standardize the agenda of the Core Safety Teams, standardized RL reports, and Good Catch program in order to better spread knowledge related to safety events. This change is a critical component of patient safety and heightened leadership involvement and awareness of the scope of events occurring across their assigned areas. The new structure keeps SRS (RL Risk) data in a highly visible position in the organization and allows us to take swift action for newly identified patterns or trends.
Cynthia Gordon, Administrative Director of Quality Office
Duke University Health System