Patient-reported incidents help to understand and reduce harm

Health system leaders, and those managing healthcare organisations, are increasingly trying to find the right way to use the views and experience of patients to make the services that they provide better and safer. The traditional path is to start with data. But the days when a provider of care could pride itself as being patient-centred purely by capturing patient feedback on its services have long gone. Today, the emphasis is on outcomes defined by patients: so-called patient-reported outcome measures.1 For example, The International Consortium for Health Outcomes Measurement2 defines outcome as: ‘The results people care about most when seeking treatment, including functional impairment and the ability to live normal, productive lives’.

There can be no area that people receiving health services should care more deeply about than being protected from the risk of avoidable harm. For the past decade, governments, health systems, providers of care and professional bodies around the world have placed a great deal of faith in incident reporting systems as the main route to safer care. Large volumes of such reports have been accumulated: in England and Wales, for instance, the database of patient safety incidents stands at 12 million.3 Yet, taking a global perspective, …