Critical Incident Data Research Articles

Further evolving the critical incident technique (CIT) by applying different contemporary approaches for analyzing qualitative data in CIT studies

PurposeThe critical incident technique (CIT) is widely used in many disciplines; however, scholars have acknowledged challenges associated with analyzing qualitative data when using this technique. Therefore, the purpose of this article is to address the data analysis issues that have been raised by introducing some different contemporary ways of analyzing qualitative critical incident data drawn from recent dissertations conducted in the human resource development (HRD) field.Design/methodology/approachThis article describes and illustrates different contemporary qualitative re-storying and cross-incident analysis approaches with examples drawn from previously and recently conducted qualitative HRD dissertations that have used the CIT.FindingsQualitative CIT analysis comprises two processes: re-storying and cross-incident analysis. The narrative inquiry–based re-storying approaches the authors illustrate include poetic narrative and dramatic emplotting. The analytical approaches we illustrate for cross-incident analysis include thematic assertion, grounded theory, and post-structural analysis/assemblages. The use of the aforementioned approaches offers researchers contemporary tools that can deepen meaning and understanding of qualitative CIT data, which address challenges that have been acknowledged regarding the difficulty of analyzing CIT data.Research limitations/implicationsThe different contemporary qualitative approaches that we have introduced and illustrated in this study provide researchers using the CIT with additional tools to address the challenges of analyzing qualitative CIT data, specifically with regard to data reduction of lengthy narrative transcripts through re-storying as well as cross-incident analyses that can substantially deepen meaning, as well as build new theory and problematize the data through existing theory.Practical implicationsA strength of the CIT is its focus on actual events that have occurred from which reasoning, behaviors, and decision-making can be examined to develop more informed practices.Originality/valueThe CIT is a very popular and flexible method for collecting data that is widely used in many disciplines. However, data analysis can be especially difficult given the volume of narrative qualitative data that can result from data collection. This paper describes and illustrates different contemporary approaches analyzing qualitative CIT data, specifically the processes of re-storying and cross-incident analysis, to address these concerns in the literature as well as to enhance and further evolve the use of the CIT method.

Intensive Care Unit Critical Incident Analysis as an Objective Tool to Select Content for a Simulation Curriculum.

The intensive care unit (ICU) offers a unique environment where emergency events are frequent, high-stakes, and carefully documented, which makes it an ideal setting to research the specific technical skills, which are deployed during such events. This study aimed to describe a method of objectively identifying skills and scenarios, which should be prioritized for inclusion in a simulation curriculum. A retrospective audit of all available critical incident data (11 months) from a 36-bed tertiary ICU was performed. Code blue events were analyzed. Data were coded according to a rubric based on Le Guen and Costa-Pinto ( Intern Med J. 2020;51(8):1298-1303) tallying the occurrence of common ICU scenarios and skills.Documentation of each event was analyzed. The frequency with which a skill or scenario appeared in these events was considered as "high frequency" if it occurred in more than 20% of the events.The trainees' confidence in a particular skill was assessed by means of a self-assessment survey questionnaire (based on an anchored 6-item rating scale). One hundred twenty-one incidents were analyzed. Sixteen were eliminated because of insufficient documentation. The most common skills during these emergency events were familiarity with the advanced life support trolley (34% of events), electrocardiogram (ECG) rhythm strip interpretation (32.4%), and the operation of an external defibrillator (29.5%).Most trainees surveyed are preparing to undergo training in anesthesia (58%) or intensive care (28%). Specialized areas of expertise (troubleshooting an extra-corporeal membrane oxygenation (ECMO) circuit or intra-aortic balloon pump) had the lowest confidence scores (average scores of 0.81 and 0.72). We highlighted a novel, reproducible, and objective methodology by which critical incident data can be integrated with trainee self-assessment to generate a targeted simulation curriculum.

Using critical incident data to promote paediatric medication safety: a regional quality improvement initiative in Northern Ireland

Background: Medication errors in children are a common cause of serious avoidable harm. Existing quality improvement (QI) measures, hampered by lack of evidence about errors’ characteristics and causes, have had limited impact. Critical incident data can provide this information but remain an underused resource in guiding QI. Aim: To describe a programme of service […]

Characteristics of Reported Pediatric Medication Errors in Northern Ireland and Use in Quality Improvement.

To protect children from harm, clinicians, educators, and patient safety champions need information to direct improvement efforts. Critical incident data could provide this but are often disregarded as a source of evidence because under-reporting makes them an inaccurate measure of error rates. Our aim was to identify key targets for pediatric healthcare quality improvement. The objective was to evaluate the types, characteristics, and areas of risk within reported medication errors in pediatric patients. We conducted a retrospective study of a large regional dataset of 1522 pediatric medication errors reported from secondary care between 2011 and 2015, including all hospitals and community pediatric settings in Northern Ireland. The following characteristics were included: error severity, patient age, drug involved, error type, and area of practice. Two academic pediatricians, a senior medicines governance pharmacist, a Reader in Pharmacy Practice, and a Professor of Medical Education analyzed the data. Validity checks included comparing the findings against key published literature and discussion by a practitioner panel representing five multidisciplinary stakeholder groups. Neonates, particularly in intensive care, were implicated in 19% of all errors. The medications most represented in risk were antimicrobials, paracetamol, vaccines, and intravenous fluids. The error types most implicated were dosing errors (32%) and omissions (21%). Incident reports identified neonates, a shortlist of drugs, and specific error types, associated with modifiable behaviors, as priority improvement targets. These findings direct further study and inform intervention development, such as specific training in calculations to prevent dosing errors. Involving experienced practitioners both endorsed the findings and engaged the practice community in their future implementation. The utility of incident reports to direct improvement efforts may offset the limitations in their representativeness.

Suicide prevention in community mental health: changing systems

Purpose This paper aims to describe a performance improvement process related to suicide assessment in a community mental health center. As suicide rates rise in the USA, it is crucial that community mental health providers are capable and comfortable to assess for suicide risk among individuals with mental illness. Support for healthcare providers is emphasized in the quadruple aim model of enhancing healthcare delivery and patient experience. The quadruple aim model is applied in the present performance improvement project in a community mental health center. Design/methodology/approach An interprofessional team used provider survey responses, critical incident data and other stakeholder input to implement a new assessment mechanism and education plan to support direct care staff to address suicide risk. Findings Although the rate of patient death by suicide at the community mental health center is low, managing risk is a frequent provider concern. Providers’ comfort assessing and managing suicide risk varied widely based on survey responses. A structured suicide assessment process was implemented to offer clarity and direction for providers. Education to address assessment and management was designed and implemented. Research limitations/implications Suicide data were retrospective and limited to known deaths, thus there may have been higher numbers of deaths by suicide historically. Providers’ comfort with suicide risk management was based on self-report and future work should also integrate skills-based assessment. Originality/value Improving the provider experience in mental health care must be explored. Focusing on provider input and voice in suicide-related efforts in community settings is a step toward integrating the quadruple aim ideals into mental health care.

Restraint and Critical Incident Reduction Following Introduction of the Neurosequential Model of Therapeutics (NMT)

ABSTRACTChildren with developmental trauma are at risk for severe and complex behavioral problems, often requiring long-term residential and day treatment. The Neurosequential Model of Therapeutics (NMT) is a developmentally sensitive approach to clinical work with a capacity-building component focusing on attachment, the impact of maltreatment and trauma, and emerging concepts in developmental psychology, neuroscience and traumatology. Research has demonstrated its effectiveness with trauma-exposed populations. NMT training may help providers working with trauma-exposed youth prevent critical incidents and reduce restraints. Restraint and critical incident data were obtained from 10 organizations providing residential and/or day-treatment services following exposure to, or certification in, the NMT. Data from the Pre-NMT Introduction period through to the Maintenance phase of NMT Certification were used to examine changes in restraints and critical incidents across phases of NMT exposure/certification. Multilevel logistic regression models suggested that NMT exposure and/or certification was associated with significant reductions in restraints and critical incidents. Reductions were sustained throughout the Maintenance phase. Estimates of potential staff hour and financial savings associated with these reductions are discussed. Implementation of the NMT in residential and day-treatment settings may result in staff, behavioral health provider, and organization-level changes that reduce critical incidents and restraint use.

Go/no-go decision in anaesthesia: wide variation in risk tolerance amongst anaesthetists

BackgroundThe variability in risk tolerance in medicine is not well understood. Parallels are often drawn between aviation and anaesthesia. The aviation industry is perceived as culturally risk averse, and part of preflight checks involves a decision on whether the flight can operate. This is sometimes termed a go/no-go decision. This questionnaire study was undertaken to explore the equivalent go/no-go decision in anaesthesia. We presented anaesthetists with a range of situations in which additional risk might be expected and asked them to decide whether they would proceed with the case. MethodsAn electronic questionnaire was distributed to anaesthetic colleagues of all grades in one National Health Service Trust. Eleven scenarios, all drawn from critical incident data, were presented. Participants were invited to consider whether they would proceed, how they would modify their anaesthetic technique, and to predict whether a colleague with similar experience would make the same decision. Textual responses were analysed qualitatively. ResultsThe scenario response rate was 28%. Consultants were significantly more likely to proceed than trainees. In no scenario was there absolute agreement over whether to proceed, even in scenarios where national guidelines would suggest a case should be cancelled. Thematic analysis suggested a wide variability in what anaesthetists consider acceptable or professional behaviour. ConclusionsIt is clear that safety decisions cannot be made in isolation and that clinicians must consider operational requirements, such as throughput, when making a go/no-go decision. The level of variability in decision-making was surprising, particularly for scenarios that appeared to go against guidelines.

The applicability of natural gas in Brazil—An analysis from an environmental and economic point of view

ABSTRACTThis work analyzes the applicability of natural gas from an environmental and economic point of view by identifying the attributes that interfere with the adoption of natural gas as an alternative energy source in companies, and by analyzing the relative productive efficiency of a set of equipment. The method used included a combination of the Critical Incident Technique, Conjoint Analysis, and Data Envelopment Analysis. The results will enable companies to measure the benefits of using this energy source and allow the Brazilian government to establish suitable strategies to stimulate the use of gas after its supply offer has been increased.

G524(P) Junior doctor essentials: critical incident reporting

Context The Junior Doctor Essentials (JDE) patient safety initiative was launched by a group of Junior Doctors, for Junior Doctors, in 2009. It has expanded across hospitals and specialties since. Problem Despite national initiatives, the prevalence of inpatient iatrogenic harm remains high. Transition from student to foundation doctor is challenging; new job pressure, combined with clinical inexperience increases the risk of error. Transition from adult to paediatric medicine is equally difficult. Empowering junior doctors to identify unsafe processes and implement mitigating solutions cultivates a patient safety culture. Junior Doctors Essentials, a junior doctor-led initiative, draws on their experiences to identify likely mistakes. Assessment of problem and analysis of its causes At the project’s inception, a focus group identified information foundation doctors considered would have eased transition into work. Their findings were augmented by organisational recommendations from The Medical Director. Since then, the model has been modified to place responsibility for designing the cards and gaining governance approval with locally nominated team leads, guided by the project team and informed by Critical Incident data. This has allowed the project to scale coherently across hospitals and departments nationwide. Intervention Following review of departmental patient safety issues and Critical Incidents, ten double-sided ‘credit-cards’ highlight essential information. These are distributed to junior doctors at induction attached to a belt clip enabling portability and are immediately available for consultation in any situation. Study design Junior Doctors are consulted annually to review each topic area’s subjective effectiveness at protecting patient safety. More recently, the effect of the introduction of cards on Critical Incident rates was evaluated. Strategy for change Survey results from the last four years have been presented to local, regional, national and international audiences. In presenting this formal critical incident data, we hope to expand the project further. Measurement of improvement Local paediatric Critical Incident reports were evaluated pre- and post- JDE card introduction. We used strict inclusion and exclusion criteria to ensure we reviewed incidents that would involve the group of staff using the cards. Critical Incident data from the year before the cards’ introduction shows that 33% of incidents would have been covered by information on the cards. Over a one-year period since their introduction, only 1 incident (3.2%) was covered. It was incidentally noted that some Critical Incidents reported were a result of errors made by other teams with regular contact with our group of paediatric patients. We are considering expanding the cards locally. We also detected recurrent incidents regarding prescribing errors and use of the DKA protocol. These will now likely be included in the next update of the cards. Effects of changes Objectively, our review of Critical Incident data suggests the cards have made a genuine clinical impact. Subjectively, the cards are well received by their target audience. Significantly, 100% of doctors surveyed would recommend the cards to future cohorts. Lessons learnt The culture of reporting critical incidents has changed over recent years and most members of staff are aware of the importance of this in enabling change. We therefore noted that total number of critical incidents reported has dramatically increased over the last few years. This may have affected our data. Message for others By encouraging access to guidelines, policies and procedures the cards help prevent clinical errors and promote patient safety. They alleviate stress and improve efficiency, enabling increased patient contact and clinical decision-making. This cost-effective project could be expanded nationwide across departments and specialities, and our work to identify an objective measure of success will help others in making the case for change in their own departments.

Learning From The Past: Dual Credit

This study involved identifying, categorizing, and comparing critical incidents related to qualifying dual credit high school students’ decisions to enroll or not to enroll in dual credit coursework in either a traditional or early college high school. The purpose of the study was (a) to identify the reasons qualifying students decide to enroll in dual credit courses in a traditional or early college high school and (b) to identify the reasons qualifying students choose the traditional versus the early college high school. For this qualitative study, the research method employed was the Critical Incident Technique (CIT) developed by John Flanagan in 1954. The study employed a written survey to obtain demographic information and the critical incident data. The study was conducted by appointed high school counselors at both high schools—traditional and early college. Both schools were located within the same school district. Total participants in the study totaled 139. The researcher, along with the help of a dual credit expert panel, identified, categorized, counted, and reported a total of 643 incidents: 340 effective and 303 ineffective critical incidents. For both enrolled traditional and early college high school students, “Incentives and Challenges” was the most frequent reason students cited for enrolling in dual credit. Both types of students also indicated “Culture/Atmosphere” as the top reason they chose to attend one school versus the other. Not enrolled traditional high school students cited the “Advanced Placement Course” category as the top reason they chose not to enroll in dual credit. These students also cited “Culture/Atmosphere” as the main reason they chose the traditional versus the early college high school. Not enrolled early college high school students cited “Personal Hindrances” as the key reason for not enrolling in dual credit. This same category was also cited as the top reason that early college students gave for choosing the early college versus the traditional high school. Keywords: dual credit, high school students, early college high school, critical incidents

Organizational Outcomes Following Traumatic Workplace Incidents: A Practice-Based Exploration of Impact of Incident Severity Level

Traumatic workplace events (critical incidents) occur with unfortunate regularity and with significant repercussions for affected organizations. Critical incident stress management (CISM) units, often a specialty component of employee assistance programs, provide consultation and support for workplace incidents. While CISM seeks to support both individual and organizational outcomes, trauma research oriented toward individual traumatic stress dominates the literature, mirroring practitioner training that tends to emphasize clinical over organizational practice. This research contributes to less-prevalent studies that explore organizational-level outcomes. Despite the facts that social workers play a central role in critical incident response and CISM units collect massive amounts of practice data, there are no published social work studies capitalizing on the potential of existing critical incident data. Employing the methodology of clinical data mining, this practice-based, exploratory research examines the propositions that incident severity level associates with several post-incident organizational outcomes. Several findings translate into considerations for evidence-informed CISM practice in the areas of intake assessment, organizational consultation, and incident response planning.

The WHO surgical safety checklist in a dental‐teaching hospital department of oral surgery – a model for implementation

AbstractIntroductionThe World Health Organisation's (WHO) surgical safety checklist was introduced in 2008. We describe a model for implementation of the surgical safety checklist in an oral surgery‐teaching department and present the results of an audit of compliance as well as a review of relevant critical incidents.MethodAn adapted checklist for all surgical procedures was developed and introduced into our oral surgery‐teaching department as a pilot in 2009 and as a protocol in 2010. Feedback regarding the pilot phase of checklist implementation was obtained from clinical staff, and 2 years of audit data relating to compliance with the surgical checklist was collected. Submissions of critical incidents over a 4‐year period, prior to and after surgical checklist introduction, were also analysed.ResultsFeedback in the pilot phase of surgical checklist implementation from clinical staff was generally positive. Audit results display increasing levels of compliance with the checklist process in our unit. Two out of 102 critical incident reports reviewed were found to be relevant to the surgical checklist process and are presented.ConclusionThe WHO surgical safety checklist can be successfully implemented in an oral surgery‐teaching hospital setting. Levels of compliance with the checklist in our unit are high. Demonstrating an improvement in outcomes since the introduction of the checklist is a challenge, but there is limited evidence of improved patient care from reviewing critical incident data in our unit.

Can't we all just get along? Emotions and the team guiding experience in adventure tourism

Despite the volume of research identifying the importance of experiences and emotions in consumption and the impact of tour guide behavior on client experiences, investigations of guide experiences in adventure tourism destinations are limited. In particular, the impact of guide-to-guide interactions, rather than guide-to-client interactions, on experiences is needed. This study investigated interpersonal interactions and emotional experiences that occurred while working in a river guiding team in an adventure tourism destination. Critical incident data was collected by an adventure tourism guide over 112 days and used to inductively analyse emotional experiences and patterns in guide-to-guide relations. Findings highlighted potential factors associated with the experience of both positive and, more frequently, negative basic emotions in the adventure team guiding interactions in this study. This investigation appears to be the first analysis of the emotional experience of team guiding in adventure settings. The importance of studying guide interactions, implications of the findings for tourism destination management and operators, and future research directions are discussed.

Influence of Sport Education on Group Cohesion in University Physical Education

The Sport Education (SE) curricular model incorporated within university physical education Basic Instruction Program (BIP) may increase group cohesion. This study’s purpose was to identify student perceptions of a BIP course taught within SE, and investigate group cohesion in differing activity content. Participants included 430 students enrolled in 25 BIP classes delivered in SE. A mixed method design included multiple data collection: critical incident, interview, and Physical Activity Group Environmental Questionnaire (PAGEQ). Lifetime skill and competitive sport class participants reflected more group cohesion than exercise class participants. Exercise class participants reported lower task cohesion than other groups, p < .05. Sport participants reported higher social cohesion than lifetime skill participants, whose responses were higher than exercise participants, ps<.05. Findings from critical incident and interview data provided further support for the PAGEQ results. We suggest that exercise classes may not spontaneously lend themselves to cohesion; thus, teachers need to be more creative in designing SE for exercise classes to increase cohesion.

Google and the scholar: the role of Google in scientists' information‐seeking behaviour

PurposeThis paper aims to demonstrate the role that the Google general search engine plays in the information‐seeking behaviour of scientists, particularly physicists and astronomers.Design/methodology/approachThe paper is based on a mixed‐methods study including 56 semi‐structured interviews, a questionnaire survey of 114 respondents (47 per cent response rate) and the use of information‐event cards to collect critical incident data. The study was conducted at the Department of Physics and Astronomy at University College, London.FindingsThe results show that Google is the tool most used for problem‐specific information seeking. The results also show the growing reliance of scientists on general search engines, particularly Google, for finding scholarly articles. Initially, finding scholarly articles was a by‐product of general searching for information rather than focused searches for papers. However, a growing number of articles read by scientists are identified through the Google general search engine and, as scientists are becoming more aware of the quantity of scholarly papers searchable by Google, they are increasingly relying on Google for finding scholarly literature.Research limitations/implicationsAs the only fields covered in the study were physics and astronomy, and the research participants were sourced from just one department of one institution, caution should be taken in generalising the findings.Originality/valueThe data are based on a mixed‐methods in‐depth study of scientists' information‐seeking behaviour which sheds some light on a question raised in past studies relating to the reason for the high number of articles identified through Google.

Vital signs for virtual teams

This study explores how team leaders sense the need for technology adaptation intervention in distributed, computer-mediated (virtual) teams. Analysis and coding of critical incident data collect...

Vital Signs for Virtual Teams: An Empirically Developed Trigger Model for Technology Adaptation Interventions

This study explores how team leaders sense the need for technology adaptation intervention in distributed, computer-mediated (virtual) teams. Analysis and coding of critical incident data collected in interviews of practicing leaders produce a five-trigger model including (1) external constraint, (2) internal constraint, (3) information and communication technology (ICT) inadequacy, (4) ICT knowledge, skills, and abilities inadequacy, and (5) trust and relationship inadequacies. The resulting five-trigger model provides several key contributions including (1) a diagnostic tool for examining real, multi-trigger team technology adaptation contexts, enabling better leader training and evaluation as well as improved research on team technology adaptation and interventions and (2) a better understanding of the relationship between the technology structure strength indicators in adaptive structuration theory and the need for team technology adaptation intervention.

An interpretive analysis of interpersonal communication: a case study from elite rugby union match officiating

During the last two decades there has been a rapid expansion in the study of interpersonal communication. This has coincided with a move towards increasingly interpretive or cultural perspectives to examine the stories, symbols, rituals, roles, and communication practices and performances of organisations. In this paper a methodological protocol is presented for researching the communication behaviours of elite match officials in rugby union. Critical incident data from referees on the International Rugby Board’s merit-based list were captured during international matches during the 2001-2002 season. They were then subjected to expert review (by panels including referees, referee coaches, referee managers, assessors and performance analysts), and later to content analysis (which established stable patterns of referee behaviour). This process generated an empirically derived theoretical model of referee communication which was then evaluated from within the practice community of rugby union referees. It received support from them for its accuracy and as a pedagogic tool for explaining effective referee communication practice.

Influence of a hybrid Sport Education—Teaching Games for Understanding unit on one teacher and his students

Background: Sport Education (SE) and Teaching Games for Understanding (TGfU) are two curriculum models that were developed to help students participate in fair and equitable ways and challenge their thinking beyond the replication of techniques and skills. Given that the general aim of both models is to employ more democratic pedagogies and provide sporting experiences which really allow students to learn how to play well, and considering both models attempt to realize this goal in slightly different ways and have different foci, it would seem logical that a coalition of the two might lead to some real pedagogical breakthroughs. Purpose: To provide descriptive, detailed information about the researcher's experiences and the students' reactions to a unit designed following the structure of SE (seasons, formal competition and student roles), but with the skills and tactics taught using problem solving and guided discovery approaches rather than a more command style. Participants and setting: 29 sixth-grade students (11 boys and 18 girls) at a middle class primary school in a metropolitan Australian capital meeting daily for 30 minutes over a 5-week period. Intervention: A 22-lesson hybrid season of ‘batting and fielding games’ formed the basic content of instruction. The organizational structure of the unit was pure SE, however the main pedagogical style employed was pure TGfU. Research design: The design followed that of a ‘teaching experiment’ having four foundational goals: (i) to examine teaching, learning and subject matters as part of a complex system, (ii) to describe the learning of subject matter as it occurs in the classroom, (iii) to identify from the teacher's perspective the issues, problems and challenges that arise during teaching, and (iv) to develop, refine or provide illustrations of theory. Data collection: Following each lesson, each student completed a ‘critical incident reflective sheet’. Four ‘tactics quizzes’ were given throughout the season. Each team designed its own batting and fielding game using a ‘game design form’. At the completion of the season, each team participated in a group interview that explored why they chose to incorporate certain rules or equipment into their own games and how they would teach the tactics of their games. Data analysis: Critical incidence data were sorted into thoughts and perceptions, and the frequency of thoughts and perceptions within each category and subcategory were computed. Tactical quizzes were analyzed to determine the number of students who provided an appropriate response to the scenario. Interview text was reduced to a series of thoughts and perceptions, and these were then coded and categorized using the same procedure employed during the analysis of the critical incident data Findings: The students responded well to the myriad of problems they were asked to solve and by the unit's conclusion, were able to understand, appreciate, and execute a number of rudimentary batting, bowling/pitching, and fielding tactics and strategies and some which were fairly sophisticated. They also understood the overarching principles, rules and structures of batting/fielding games, appreciated their importance, and were able to transfer them from one game to another. Particularly impressive in this respect, was their ability to include risk/reward strategies and avoid problematic skills in the games that they invented. Conclusions: It is important to emphasize that combining the two models did not weaken most of the structural advantages research has suggested SE has over more traditional curricula. However, combining SE and TGfU placed more emphasis on the teacher to drive and give momentum to the proceedings and, therefore, teaching was more labour-intensive. In particular, we concluded that to be successful when delivering a hybrid SE-TGfU unit, a teacher would have to possess superior content and pedagogical content knowledge.

Incident Clustering: Diagnostic Approach for Assessing Usability of Intersections and Other Road Sites

During the course of an FHWA-sponsored research project, driver errors in crashes and near-crashes (i.e., critical incidents) were investigated, and an analysis approach was developed with which to identify infrastructure-related and non-infrastructure-related problems at intersections and other roadway sites. Referred to as a specific site critical incident analysis, this analysis approach consisted of four general steps: ( a) selection of a site, ( b) careful review of the site's critical-incident data, ( c) determination of the potential critical-incident contributing factors, and ( d) identification of incident clusters. An incident cluster is a group of critical incidents with similar characteristics that occur at the same location. From these incident clusters, researchers gained insight into potential infrastructure-related and non-infrastructure-related causal factors associated with critical incidents and, subsequently, could redesign solutions. An overview is presented of the incident cluster approach, as is an example analysis conducted for the driver error project.