When Things Don’t Go As Planned

February 25, 2014

The importance of Accident & Incident Report Forms

Maggie Cattell
Aquatic Coordinator
Florida Southern College

It was my first week on the job and my first major event to be working. I was a risk management mentor. A job title that meant little to anyone who worked outside of our own Campus Recreation staff but to those who did work there I was the expert on anything accident or incident related. Whenever something occurred, it was my job to ensure the student staff acted accordingly and my responsibility to step in if they didn’t. I should have known that the combination of the high intensity water polo matches taking place and my own personal magnetism for accidents that something would happen. I was making my rounds when the call came over the radio for an ambulance. I and the supervisor on duty stepped up our fast walk to a run when we heard it was a head/neck/back injury. The lifeguard speaking on the radio was calm and descriptive so I expected for the response I was about to witness to be organized and thorough.

What I found was an upset and concerned lifeguard who was being told that the trainers would take care of the participant and that her services were not necessary. The lifeguard was anxious to provide the care she had been trained to give, the supervisor was irate that our emergency action plan wasn’t going as expected, however I wasn’t sure if we had authority over athletic trainers to call them off. The last thing this situation needed was a power struggle and I chose to reassure the staff and stand by in case the trainer changed their mind and did want our assistance. The toughest part of that day: finding a way to describe this accident in a report form.

Let’s face it, as often as we practice EAPs, train staff, and prepare for the worst, things rarely go as planned. Equipment breaks, staff panic, and coaches choose to call trainers instead of calling an ambulance. An effective EAP depends on all factors affected to be on the same page and unfortunately for many, our facilities are multifaceted and unpredictable. In the above situation, my main concern was patient care. When it became clear that our desire to follow the EAP we were trained with would hinder and delay care to the participant, my next concern was making sure to document exactly what happened so liability would not fall on Campus Recreation. Interestingly enough, I felt more comfortable with the EAP that didn’t go as planned then finding a way to describe what had just happened on a piece of paper. I was heavily trained in the EAP but not in the follow-through that needed to take place after each accident or incident.

The above scenario illustrates 3 different parts of the Risk Management system:
The before – this comprises of your staff training and what you do at your facility to help prevent accidents and incidents from occurring.
The during – this is what takes place once an accident or incident has occurred. It is the response of the staff and the care provided.
The after – this consists of the documentation, follow up, and evaluation.

The after is normally the area that is forgotten or neglected. Some of this is because of lack of knowledge. However, the necessity of proper accident reporting becomes clear when a possible lawsuit is facing your facility. Someone’s claims in court against you or your staff will be hard to prove false if the accident report form contains illegible handwriting, crossed out statements, and no date.

Most facilities do possess some type of report form that they use for accidents or incidents but many mistakes are made when it comes to creating new report forms or utilizing the ones already made:

• An accident/incident report needs to be easy to read and user friendly. Let’s remember that most of our staff are students who tend to be easily distracted and sometimes not detail friendly. Creating sections, utilizing bold or italics, and putting diagrams or pictures are all ways to help our staff provide as much detail as possible.
• An accident and incident are NOT the same thing and therefore should NOT be the same form. The difference between an Accident and an Incident:
  An accident is a situation where an injury or illness occurred.
  An incident can be something that disrupts the normal operation of your facility and can sometimes vary in definition based on the organization.

These differences in definition should elude to the fact that these each need to have different information collected to know what happened. Using the same form will result in missing or unnecessary information.

• An accident/incident report needs to be easily accessible. Putting these reports behind lock and key in an office or drawer is not the way to entice staff to fill them out. Put them in places where they are seen and easy to reach. Maybe on your supervisor’s clipboard or by the first aid supplies. Make sure there are plenty of copies. If they are seen, they are more likely to be remembered, and therefore more likely to be used.

• Staff members need to be trained on how to use these forms. Believe it or not, as much time as you put into making these forms organized and easy to follow, staff still need to be shown how to fill them out and what to do with them after they are done. Explaining when they need to be filled out, where they are kept, and answering questions about those “what if….” situations are important even if they seem tedious and time consuming. The more the staff knows about the process, the more they can help themselves.

So, with the above being discussed, the question now is: What should your forms have on them? Every facility has a different set up for their report forms. Your forms need to reflect the space your organization is responsible for, the participants who use those spaces, and what types of accidents/incidents occur on a more frequent basis. Despite facility differentiations, a general outline of an accident and incident report form is as follows:

• Date, time, and location of occurrence — some facilities also ask for which department the accident/incident occurred such as intramurals or athletics so that in cases of multi-use areas there can be a better idea of who was involved
• Contact information of participant — General information about the participant might be name, birth date, phone number, address, and student identification number
• If 911 was called – information in this section might include getting badge numbers of officers/EMTs dispatched, time of arrival, what they did when they were there, and time of departure
• Describing what happened — This needs to be an area where staff can write what happened. If they weren’t there to witness the accident/incident, this would be the place where they recount what the participants said happened
• Describing the staff response — Employees should document with as much detail as possible in this section and put information such as how they were notified, what they saw, and what care they provided
• Writing area for additional comments — Often this section is overlooked and underutilized but in situations that are complicated or not “black and white” this is where staff can make comments that don’t fit in to other categories such as if it took the ambulance 20 minutes to arrive, if the participant kept changing their story, or other details that might be important if a lawsuit was filed.
• Signatures — signature and date from the participant and employee who filled out the form are necessary.
• Please remember that each facility is different, and report forms may need to be customized to the situation. Lastly, here are reminders of some things that you DON’T want to do with accident or incident report forms:
• Don’t ask for unnecessary personal information about the participant — use caution when asking for social security numbers or other personal information that isn’t pertinent for your records (height, weight, marital status, income, insurance information, grade point average, driver’s license number, etc.). Decide what is right for your facility and limit it to necessary information.
• Don’t ask for causation — as much time and energy (not to mention money) we put in to training ourselves and our staff: we aren’t doctors. We can’t determine or diagnose what is wrong. Make sure your staff are aware of this and use caution when choosing terminology in report forms.
• Don’t let report forms become a distraction — despite all that has been discussed, participant care should ALWAYS take precedent over filling out a report form. Make sure to train staff about reporting but also stress that their attention needs to be on the patron and the patron’s current condition.
• Don’t forget about the follow up — remember to call participants after most accidents to ensure the care they received was sufficient, talk to staff and discuss what they did well and what they can work on, and keep report forms on file for the required time set by each state (normally around 7 years).
• Don’t forget to utilize the information gathered — use the report forms to track trends that occur in your facility. Is one area on the basketball court always slippery and that’s why participants fall? Is one intramural sport more dangerous than others? What can you do in the future to help patrons and prevent these accidents from occurring again?

To download sample Accident and Incident report forms, click www.sportrisk.com/_archive/Accident_&_Incident_Report_Forms