A knowledge-based framework for clinical incident management

Clinical incidents, which occur during the provision of health care, can be costly and deadly. Over three-quarter of these incidents is preventable ac cording to the studies in general practice in Australia (Bhasale, A., Mille r, G., Reid, S., & Britt, H., (1998). Analysing potential harm in Australia n general practice: an incident-monitoring study. MJA, 169, 73-76). It is i mportant that we learn as much as possible from these incidents to prevent them in the future and improve quality of care. This paper introduces a hol istic system, which amalgamates case-based reasoning, rule-based reasoning, causal-based reasoning and an ontological knowledge base for managing clin ical incidents in general practice. Clinical incident management includes i ncident analysis, incident case browsing, statistics and explanation. The s ystem enables health professionals to share the medical incident informatio n, which has caused harm and can cause potential harm. The re-use of such i nformation may prevent or mitigate human or medical errors. Such a hybrid a pproach provides an effective management of adverse clinical incidents for quality improvement in General Practice. (C) 1999 Elsevier Science Ltd. All rights reserved.