Beaver County System of Care Incident Reporting

Overview Reasons for Reporting – why it’s important Two different reporting systems Managed Care Organization – MCO Adverse Critical BC Critical Incident system – all residents Early Warning Frequently asked questions Helpful hints Communication

Reason for Reporting: Why it’s important Continuous Quality Improvement Identification of trends and/or improvement opportunities prevent future incidents Improve system functioning Monitoring to ensure member safety and high quality services increase opportunities for intervention Because it is required.

Reporting Systems: MCO Staff serving MCO Members only: When do I report? Within the next business day from the incident date. Where can I find the reporting form? Critical Incident Log is located under Quality Management Forms at http://vbh-pa/com/provider/prv_forms.htm How do I report? Risk Management Fax: 1-855-287-8491 Risk Management Email (encrypted only): criticalincident@beaconhealthoptions.com Contact Quality Management Staff: Nicole Brown 724-744-6327

Critical Incident/Quality of Care Log Reporting Form: MCO Critical Incident/Quality of Care Log VBH Risk Management Fax 855-287-8491 Encrypted Email: Criticalincident@beaconhealthoptions.com Critical Incident Provider Preventable Condition Quality of Care Date Received:       Date of Incident: Date of Log: Reporter Information: Incident Reported By: Provider VBH-PA Staff Other Reporting Staff Name: Provider Name: Provider Phone: Provider Address: Member Information MAID #: First Name Last Name Date of Birth Age County: MH Diagnosis: D&A Diagnosis: Medical Conditions: Provider and Level of Care at time of incident: (if same as reporting provider, please note as “same”) Incident Code:       Please provide a brief description of incident:   Name of VBH-PA staff person accepting incident report: ***** Risk Management Information Faxed (email):      Entered:      Comments:

MCO Reportable Incidents: Suicide/attempted suicide Homicide/attempted homicide Death Allegations of sexual/physical abuse Assault Absent w/out leave with or w/out risk to self/others Undesirable events inconsistent with routine patient care Breach of confidentiality Parent/guardian taking child AMA – Against Medical Advice Accidental injury Medication/Treatment errors Adverse reaction to medication/treatment Fire setting/property damage Temporary closure of a facility Possession of a deadly weapon Outbreak of a serious communicable disease Other Administrative Discharge Any real or threatened litigation in a case

Reporting Systems: Beaver County Staff serving all Beaver County residents: When do I report? Within the next business day of the incident date. Where can I find the reporting form? BC Critical Incident Reporting form is located at http://www.bc-systemofcare.org/incident-reporting/ How do I report? Send all incidents to BCBH on the BC Reporting Form via fax: To: Elisia Majors & Stephanie Santoro Fax: 724-847-6229

Beaver County Behavioral Health Reportable Incidents: Critical Incidents: CRIT - Abuse - Physical/Sexual CRIT - Outbreak of Contagious Disease CRIT - Apparent Homicide By Client CRIT – Overdose CRIT – Arrest CRIT - Serious Assault CRIT - Attempted Suicide CRIT - Suicide CRIT - Client Injury - Accident/Intentional CRIT - Client Injury - Restraint/Seclusion CRIT - Community Hosp - Involuntary (302) CRIT - Community Hosp - Voluntary (201) CRIT – Death CRIT - Failure to Follow Duty to Warn CRIT – Fire CRIT - Hospitalization – SMH* CRIT - Medical Hospitalization CRIT - Medical Tx Error CRIT - Missing Person CRIT - Misuse of Client Funds CRIT - Other Incident-Serious Nature *admission to a state hospital

Beaver County Behavioral Health Reportable Incidents: Early Warning Incidents: EW – AMA – Against Medical Advice EW - Attempts At Elopement EW - Atypical Behavior - Change From Baseline EW - Complaints - Property Destruction/Eviction EW - Consumer Not Responding to Contact EW - E/R Visit - Behavioral/Physical Health EW - Inability to Locate Consumer EW - Indications For Increased Service/Supports EW - Police Involvement EW - Refusal to Take Medications Posing Risk EW - Sleep Pattern Change From Baseline EW - Unexcused Missed Appts - Provider

BC Incident Reporting Form

Frequently Asked Questions: When should I report? Within the next business day of an incident. Follow up later if more information is available. Who should report? All providers serving Beaver County residents. Do I have to complete all the fields? Yes. This helps us identify the person in the system. Should a supervisor review the incident report before sending it to the county? Yes. This will ensure it is complete, legible and tells what happened. Who can I contact with questions or to get forms? Elisia Majors or Stephanie Santoro 724-847-6225 http://www.bc-systemofcare.org/incident-reporting/

Helpful Hints: Type or print legibly. The date of the incident is the date the incident started. An incident might cover several dates. Use the start date but include the details and additional dates in the body of the report. Choosing a category: What take highest priority? - use your best judgement* Not sure, talk to your supervisor - Call Elisia or Stephanie Include the symptoms that lead to an ER visit and/or inpatient behavioral health admission What happened? Don’t leave the reader wondering. Hospital is not a type of housing Use relationships not names. (other than the member’s name) *Phone number is the number of the provider/program where supervisor/staff can be reached to answer any questions.

Communication: Why is communication so important? Continuity Many people are served by multiple systems and levels of care. Talk to each other about the individual, incidents and reporting requirements. Can’t report on time? Talk to the county. Make them aware of the incident and obstacles to reporting. They will work with you.

THANK YOU You have completed the Incident Reporting protocol. Please take the test! You will get a certificate once you have completed all the competencies and passed with 90% or better. The certificate will generate on its own. Print it. Give it to your supervisor