A Review of South Australia Health and Wellbeing’s Safety Learning System Report

Summary

As part of its commitment to a safe healthcare system for all South Australians (SA), the SA Department of Health and Wellbeing (DHW) has used the Safety Learning System (SLS) since 2011.

This is an incident management system that allows healthcare staff to report incidents and near misses. They are reviewed, escalated where appropriate, analysed and investigated in an attempt to prevent their occurrence in the future. The SLS is a “state-wide” system which allows healthcare professionals access to report incidents in all SA public health services and related agencies such as ambulance.

Content

This is an independent review of the SLS:

1. To consider recommendations made by the State Coroner and by independent reviews conducted in response to the Chemotherapy Underdosing that relate to incident reporting and management.

2. To determine and describe how the SLS is used across SA Health for patient incident reporting and management including:

a. adoption and uptake;

b. data extraction;

c. reporting;

d. incident management; and

e. open disclosure to patients and feedback to staff.

3. To identify factors that are impeding or may impede the use of SLS, including;

a. the culture of reporting and incident management, and

b. the availability and uptake of training and education. 

4. To determine if Datix Web, the software platform used for the SLS, meets the needs of SA Health and whether its functionality is comparable to alternative programs.

5. To make recommendation to the Chief Executive (CE), Department of Health and Wellbeing that will assist in assuring robust incident reporting and management and the sharing of learnings across SA Health.