A chemotherapy incident reporting and improvement system.

Abstract

The Vanderbilt University Medical Center (VUMC) has designed and deployed the Chemotherapy Incident Reporting and Improvement System (CIRIS), which is embedded into daily care processes. The system uses commercial information technologies, including handheld computers, to create a mobile Web-based chemotherapy incident reporting system for nurses and pharmacists. Two phases--(1) development and implementation of the CIRIS incident reporting safety registry and (2) development of the handheld-computer interface--were implemented. The final phase entails integration of the computerized order entry system into the front end of the CIRIS architecture. The voluntary incident reporting system data are stored over time for use by the multidisciplinary safety improvement team. Staff buy-in has been demonstrated by increased reporting rates, the high number of provider-initiated improvements made to the reporting tool during the first year of implementation, and specific chemotherapy safety interventions conceived from analysis of the reported data. The CIRIS model for pediatric chemotherapy safety improvement has been implemented in the inpatient setting but could easily be configured for a variety of other clinical applications in inpatient or outpatient settings. CIRIS has been effective, especially in the chemotherapy pharmacy, where incident reporting has increased dramatically.