Occurrence Variance Report

Objectives:
What is the OVR?
What to report?
Who reports?
Action taken.
• Quality is the optimal achievement of the
therapeutic benefit and avoidance of risk and
minimization of harm.
• JCI definition of quality

Harms & hazards
• Hazardous condition: a circumstance other than the patient’s own disease
that increase the probability of an adverse event.
• Near miss: +ve hazard risk with no harm.

(they have the same root cause as the sentinel events)
• Adverse effect: +ve hazard risk with harm but with no death or loss of
function.
• Sentinel event: +ve hazard risk with harm including death or loss of limb or
loss of function.
• Significant event: Certain events require intensive analysis for
identification of root causes using quality tools.
• Occurrence: an unusual event which adversely affects or threatens the

health or life of patient , visitor , employee which involves loss or
damage to personal or hospital property also includes any event may
result in adverse situation or acclaim against the organization.
• Variation: the differences in result obtained in measuring the same

event more than once.
Incident Report
(Occurrence Variance Report)
• An internal form which is

issued, to document the details
of occurrence / event, the
investigation of an occurrence
and the corrective actions
taken.
Purpose of reporting?
• Incident report is not a tool to

criticize or speculate on actions
of the staff involved.
• This report is used to identify

the facts surrounding the
occurrence.
Stop blaming others
Purpose of reporting?
• To act as a problem identification
mechanism – quality improvement
tool .
• To implement corrective measures
through root cause analysis.
Who should report?
• It is the responsibility of all staffs to immediately report details any
occurrence which may negatively impacts the care of patients.
confidentiality
• The OVR form should not be placed in the medical record.
• The term incident or error should not be used while documenting the
occurrence.
• The information contained in the OVR cannot and shall not be used
against any individual except in extreme situations.
• The OVR should not be duplicated with exception for quality
department.
• Names of involved person should not be used.
OVR Pathway
Q
T
u
h
aesta
lff
im
e
tdm
b
e
yperw
art
h
m
eo
d
n
w
t
esitn
u
es
p
p
d
ervis
aot
r
rhe
tin
m
ci
d
een
n
t
H
o
s
p
i
t
a
l
d
i
r
e
c
t
o
r
Responsibilities
• Immediate notification of the

attending physician incase of
injury and the immediate
supervisor
• Initiating the OVR form before
the end of the current shift.
• Submit OVR form to immediate
supervisor \ head of
department.
Responsibilities
• Ensures that all employees are aware of

the OVR system and how to report and
process OVR form.
Responsibilities
• Conducting immediate actions and follow up of the occurrence

• Documenting on OVR the actions taken and/or any corrective
measures taken to prevent the recurrence of the event.
• Evaluates incident if meets sentinel event criteri
• Complete the OVR with their recommendations.
• Forward the completed original OVR form to quality department
• Ensure that all employees are aware of OVR system and how to report
and process OVR form.
Responsibilities
Quality department
• Investigate all incidents.

• Root cause analysis of all
incidents.
• Document the results and the
preventive actions needed in
order to report to the top
management.
Responsibilities
Quality department
• Trending and preparing a monthly summary.

• Archiving the incident reporting files.
Responsibilities
• Review and approve corrective

& preventive actions.
• Use Just Culture Approach and

encourage staff to report
Don’t forget
• All investigations and conclusion
documentation will be in the
custody of quality department
and remained confidential.
• A near miss today could be a
accident tomorrow.
• Stop blaming others.
• Adopt just culture.

Occurrence Variance Report

Uploaded by

Copyright:

Available Formats

Occurrence Variance Report

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Occurrence Variance Report

Uploaded by

Copyright:

Available Formats

Objectives:

What is the OVR?

• JCI definition of quality

• Near miss: +ve hazard risk with no harm.

• Occurrence: an unusual event which adversely affects or threatens the

• Variation: the differences in result obtained in measuring the same

• An internal form which is

• Incident report is not a tool to

• This report is used to identify

• Immediate notification of the

• Ensures that all employees are aware of

• Conducting immediate actions and follow up of the occurrence

• Investigate all incidents.

• Trending and preparing a monthly summary.

• Review and approve corrective

• Use Just Culture Approach and

You might also like