Work

Safety Incident Reporting in Chiropractic: A descriptive analysis of an active and passive system

Year: 2026

Type: preprint

Abstract: Background Safety incident reporting systems support learning from harm, but the processes and information outputs of active and passive systems within chiropractic have not been analyzed. The Chiropractic Patient Incident Reporting and Learning System (CPiRLS) is a passive, provider-driven system using voluntary, anonymous reporting, while SafetyNET is an active, research-embedded system collecting reports from both patients and practitioners. Methods A framework analysis with a structured expert consensus method was used. Both systems were assessed against the six core categories of the World Health Organization (WHO) self-assessment framework for patient safety incident reporting systems, and their incident report data fields were mapped against the WHO Minimal Information Model for Patient Safety (MIM PS). One leader from each system completed the assessment, which was independently verified by a second leader. Four panelists without system-leadership roles rated each item independently, followed by a facilitated consensus meeting. Reporting followed the Standards for Reporting Qualitative Research. Results Neither system aligned fully with the WHO framework or model. SafetyNET scored higher on Reporting Rules and Content, including the largest single divergence in the framework: the ability to return to a reporter for further information. CPiRLS scored higher on Governance, consistent with its anonymous design. Both systems scored comparably in the mid-range on Analysis and Investigation, and both scored at the bottom of the rating scale on nearly every item within Patient and Family Engagement. Both scored equally low on providing personalized feedback to reporters. Both met most Basic MIM PS elements, with gaps in incident location, incident type, and incident outcome, and neither used standardized coding for suspected cause or contributing factors. Where one system was strong, the other tended to be weaker. Conclusions The differences between CPiRLS and SafetyNET reflect differences in design rather than in the quality of each system, and the two together align with the WHO self-assessment framework more completely than either does in isolation. Neither system can close the shared gaps alone, and the profession would be better served by using both approaches than by choosing between them.

Source: Research Square

DOI: 10.21203/rs.3.rs-11040984/v1