Quality & Accreditation¶
Track patient-safety incidents, investigate root causes, and monitor quality indicators for accreditation.
Screenshot: Quality dashboard — TODO
Medical → Quality (/medical/quality) shows open incidents, sentinel events, and indicators not
meeting target.
Incident reports¶
Quality → Incidents (/medical/quality/incidents) — report an incident by type (Adverse
Event / Near Miss / Complaint) and severity (Low / Moderate / Severe / Sentinel), with location
and patient. The lifecycle is Open → Under Investigation → Review → Closed; Severe and
Sentinel events require a root‑cause analysis (RCA).
Screenshot: Incident report — TODO
Quality indicators¶
Quality → Indicators (/medical/quality/indicators) — define indicators by category (Patient
Safety, Infection Control, Clinical Outcomes, Efficiency/Access) with a target and
direction, then record measurements per period and track Met / Not Met (rate = numerator /
denominator).
Auto‑compute from operational data — instead of hand‑entering every figure, pick a period (label + from/to) and the system computes selected indicators directly from live data — e.g. bed occupancy rate and surgery cancellation rate — and upserts the measurement. Auto rows behave like manual ones on the dashboard. All three period fields are required; a missing or invalid date shows a validation message on the page (never an error page), and the To date can't be before From.
Sentinel events escalate
High‑severity incidents are flagged as requiring RCA and tracked separately — they shouldn't be closed without a documented investigation.
Patient feedback¶
Quality → Patient Feedback (/medical/quality/feedback) — a read‑only view of the 1–5 star
ratings patients submit for their own past visits from the patient portal ("Share feedback"). Shows
the average rating and total response count, filterable by rating band, with the patient's name, MRN,
star rating, comment and submission date. There is no status or assignment here — it's a satisfaction
pulse, not a case. A patient's formal complaint is handled by the hospital's separate grievance
process (front desk/reception), not tracked on this screen.
Record change audit¶
Medical → Record Change Audit (/medical/change-audit) answers the question an auditor,
inspector or clinical-governance review opens with: who changed this record, when, and from what to
what.
Every create, edit and delete of a regulated clinical record is captured automatically — nobody has to remember to log anything, and it cannot be bypassed by editing from a different screen. The records covered today are:
| Record | Why it is watched |
|---|---|
| Patient | Identity and demographics — a changed MRN, name or date of birth is the wrong-patient vector |
| Allergy | Feeds the dispensing safety check; an allergy quietly removed is a patient-safety event |
| Consent | Consent given or withdrawn (Individual Privacy Act 2075) |
| Clinical note | Retrospective alteration of the clinical record |
| Clinical order | What was ordered, and when it changed |
| Lab test/result | Every field edit, not just the formal result amendment |
| Pharmacy dispense | Medication actually handed over |
| Controlled drug | The narcotics register |
Filter by record type, by action (Created / Updated / Deleted), or search by the user's name, the record type or the record's id. The What changed column shows each field with its old and new value side by side.
Encrypted details are recorded but not shown
Fields the system encrypts at rest — national ID, phone, email, address, next-of-kin — appear as
[redacted]. The audit still proves that the field was changed, by whom and when; it just does
not keep a second, unencrypted copy of the value.
How this differs from the PHI access audit
PHI Access Audit (/medical/phi-access) records who read a patient's chart, including
emergency break-glass access. Record Change Audit records who wrote to it. Both are
permission-gated and neither can be edited or deleted from the application.