Safety Reporting Mapping Markets: Driving Patient Safety Through Improved Reporting
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Research from the Agency for Healthcare Research and Quality showed year-over-year reductions in in-hospital patient safety events from 2010-2020. However, despite these advances, achieving a true “culture of safety" within the health system is an ongoing exercise. Many healthcare organizations still struggle with consistent safety reporting and analysis, with some studies suggesting that up to 50% of adverse events may go unreported, creating blind spots in safety monitoring.
While the factors driving underreporting are varied, a significant step health systems leaders can take to address these challenges is to implement user-friendly reporting tools with high ease-of-use, detailed training protocols, and full integration into other operational and clinical systems.
What are safety reporting systems?
Safety reporting systems are digital platforms for healthcare workers to document and track patient safety events, hazards, and concerns. They typically include features for recording incident details, severity levels, contributing factors, and follow-up actions. Modern systems integrate with electronic health records and quality management workflows, enabling real-time alerts, trend analysis, and automated reporting to regulatory bodies. They are essential tools for risk management, quality improvement, and regulatory compliance.
What is reported through these systems?
Most patient safety events fall into four broad areas:
Traditional adverse events: All events that result in harm. Common examples include: medication errors, surgical errors, communication errors, patient falls, patient misidentification, equipment failures, or hospital-acquired infections.
“No-harm” events: An unsafe situation occurred, but no patient harm resulted, such as a nurse accidentally administering medication to a patient at the wrong time, but the dosage still fell within safe pharmacological limits.
“Near misses”: Situations that could have easily resulted in an adverse event, such as a nurse catching a medication dosage error immediately before administering it to a patient.
Unsafe conditions: Not attached to a specific event but are situations that increase the likelihood of an adverse event occurring. Poor environment of care, malfunctioning equipment, or software downtime could all fall under unsafe conditions.
How does safety reporting work and why does it matter?
Safety reporting serves ethical and operational imperatives in healthcare. Reporting exists to minimize patient harm by identifying risks early and preventing future incidents. The reporting workflow typically follows this path:
Initial report: Frontline staff submit reports through a designated system when they witness or discover a safety event, like an adverse event, near-miss, or unsafe condition.
Immediate review: Unit managers and risk management teams receive these reports in real-time for quick intervention on serious events. Critical incidents trigger immediate escalation protocols to hospital leadership.
Regular analysis: Most health systems conduct monthly or quarterly reviews through interdisciplinary safety committees composed of clinical leaders, quality staff, risk managers, and frontline representatives. These teams examine significant events to identify systematic issues and necessary improvements.
Action and follow-up: The committees develop action plans based on their findings, assign responsibility for changes, and track implementation. Progress is reported through organizational quality committees and to the board.
This reporting and review approach is protected under the Patient Safety and Quality Improvement Act of 2005. This federal law provides legal protection for staff who report safety concerns and makes safety data submitted to Patient Safety Organizations (PSOs) privileged and confidential. These protections help foster a culture where staff feel secure raising safety issues.
Beyond the ethical imperative, healthcare organizations face regulatory safety reporting requirements. The Joint Commission and CMS require robust reporting mechanisms, with non-compliance risking penalties, lost accreditation, or reduced reimbursements. Strong safety reporting also helps protect against liability by demonstrating systematic efforts to address safety concerns.
Vendor Landscape
Safety reporting solutions can be sorted into a few subcategories:
Many EHRs like Epic or Meditech have built-in event reporting features, though they are less fully featured, lacking dedicated reporting dashboards and analytics or pull-through into other compliance or quality systems.
Many solutions exist as products or features within larger risk management or compliance platforms. Examples include IDInc, Performance Health Partners, or RLDatix’s Event Reporting product, which fits into the larger RLDatix Catalix platform.
Some solutions roll up into even broader operational products like Symplr Safety, one of many products within Symplr’s operations suite, which covers use-cases from provider network management to spend analysis, or Sentact OnDemand, which sits within a comprehensive safety, quality, and workforce management platform.
There are emerging AI solutions, with examples like Medinsight.ai, which uses generative AI to automatically detect, classify, and analyze adverse events in clinical settings.
Looking Ahead
More passive solutions integrated through ambient scribes or ambient sensing and alerting systems may emerge as a viable option, focusing on ensuring low friction and ease-of-use to maximize participation in reporting.
For example, suppose a patient deteriorates unexpectedly and the clinician notes, “We’ve been paging respiratory for 10 minutes.” That’s a potential delay in treatment. Ambient scribes could log a soft flag or safety tag even if the event isn’t formally reported—creating a searchable audit trail of care quality risks embedded in the documentation stream. For ambient sensing, fall detection systems built into products like Avasure could be integrated to log safety events, even when no staff member directly witnesses the event.
By increasing top-of-funnel reports without additional human intervention, these technologies could help mitigate underreporting, ultimately getting health systems closer to having a truly complete and accurate picture of patient safety and quality.