CARE MANAGEMENT SOFTWARE

Approach and key actions to manage a client incident

client incident management system cover

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Integration with a Client Incident Management System will empower service providers to effectively respond to client incidents, to be accountable for their actions, to manage the quality of their own services and to make the best use of departmental support resources, particularly in relation to the most serious incidents. This will help to improve the safety and wellbeing of all clients. The effective operation of the CIMS relies on all parties acting with transparency, integrity and accountability. In instances where the professional judgement or good faith are lacking, departmental quality assurance, monitoring and oversight mechanisms will be used to identify and act on performance issues.

CIMS: Actions and responsibilities of service providers and the department

In instances where the professional judgement or good faith are lacking, departmental quality assurance, monitoring and oversight mechanisms will be used to identify and act on performance issues. These accountability arrangements include:

  • CIMS-specific accountability arrangements, including divisional office endorsement of incident reports, quality assurance of incident investigations and incident reviews, incident data analysis and CIMS performance audits.
  • Broader monitoring and regulation mechanisms such as the Funded Organisation Performance Monitoring Framework, including key performance indicators, targets and reporting requirements.
  • Regulatory actions where there has been a breach of applicable standards, such as those made under the Children, Youth and Families Act 2005 or the Disability Act 2006.
  • External oversight bodies such as the Victorian Ombudsman and relevant commissioners.

Overview of the CIMS stages

The effective management of a client incident has five stages which are outlined above.

CIMS Stage 1: Identification and response

Identification is when an incident is disclosed to, or observed by, a service provider at any service delivery setting (for example, provider premises, outreach location, client’s home). This can include disclosure by a client, family member or other professionals, to the service provider.
Response covers the immediate activities undertaken to ensure the safety and well-being of clients, staff and visitors, preserve evidence and notify emergency services and family or other support people.

CIMS Stage 2: Reporting

Reporting captures specific information regarding the incident identified.
As part of this stage, follow-up is undertaken to ensure that the information provided in an incident notification is accurate, and service providers and the department are assured that appropriate actions are being planned and undertaken to manage the incident.

CIMS Stage 3: Incident investigation

An investigation is a formal process of collecting information to ascertain the facts, which may inform any subsequent criminal, civil, disciplinary or administrative sanctions.
In the context of this guide, the purpose of an incident investigation is to determine whether there has been abuse or neglect of a client by a staff member or another client, in relation to an allegation in a client incident report.

CIMS Stage 4: Incident review

A review is an analysis of an incident to identify what happened, determine whether an incident was managed appropriately, and to identify the causes of the incident and any subsequent learnings to apply to reduce the risk of future harm. Such reviews may be carried out by service providers (including the department) or external bodies.
Note that incident reviews are distinguished from incident investigations (above), which have a focus on determining whether there has been abuse or neglect of a client by a staff member or another client. In general, if an investigation has been carried out, there is no requirement for the service provider to undertake an incident review, so long as the investigation sufficiently covered any relevant issues of quality assurance and continuous improvement that would otherwise be considered by a review.

CIMS Stage 5: Analysis and learning

Analysis and learning includes monitoring and acting on trends identified through the analysis of client incident information to enhance the quality of service and supports to clients.
Reporting, investigating, reviewing and analysing incidents enables service providers to assess the way in which an incident has been managed, implement improvements, minimise risk and embed a continuous improvement approach which involves the client within service delivery. This, in turn, supports better client experience and outcomes.
If there are any disputes between the service provider and the departmental divisional office in regards to their obligations or interpretation of this guide, parties should make use of standard escalation and dispute resolution procedures as appropriate.

Want to speak to our friendly Digital Business Architects to see FlowLogic a friendly CIMS solution please book a webinar or call us on 1300 552 166! Alternatively send an email to our friendly Digital Architects. We will get back to you shortly.

CIMS: Responding to an incident

During the process of service delivery, different types of events will occur that affect the client. Events may have a positive, negative or neutral influence on a client. Some of these events will meet the definition of a ‘client incident’ within the meaning of this guide and therefore fall within the scope of this guide.

CIMS Objectives: The overarching aim of the CIMS is to support the safety and wellbeing of clients.

  • ensure that timely and effective responses to client incidents address client safety and wellbeing
  • ensure effective and appropriate investigation of client incidents
  • ensure effective and appropriate review of client incidents
  • learn from individual incidents and patterns of client incidents, to reduce the risk of harm to clients, and improve the quality of services and the service system
  • ensure accountability of service providers to clients
  • protect and maintain the personal and sensitive information of clients, service provider staff, carers and others from whom a service provider collects personal information for the purpose of client incident reporting.

CIMS Principles: The following principles underpin the design of the CIMS, and guide all actions undertaken

  • Client-centred – management of a client incident is respectful of and responsive to a client’s preferences, needs and values while supporting the client’s safety and well-being.
  • Outcome-focused – management of a client incident should enhance a client’s safety and well-being first and foremost.
  • Clear, simple and consistent – the client incident management system is easily understood and accessible to all stakeholders across the service system, and applies consistently to all service providers, both department-delivered and department-funded organisations.
  • Accountable – service providers have primary accountability for managing the response to client incidents. Each party involved in the management of a client incident understands their role and responsibilities and will be accountable for decisions or actions were taken in regard to an incident.
  • Continually improving – the client incident management system facilitates the ongoing identification of issues and implementation of changes that result in better outcomes for client safety and wellbeing.
  • protect and maintain the personal and sensitive information of clients, service provider staff, carers and others from whom a service provider collects personal information for the purpose of client incident reporting.
  • Fit for purpose – the client incident management system is capable of meeting the objectives of the system.
  • Co-production intensity proportionate – the nature of any investigation, review or other actions following a client incident will be proportionate to the harm caused to the client and the risk of future harm to the client.y

A client incident is defined as:

An event or circumstance that occurred during service delivery and resulted in harm to a client.
Note that this excludes incidents that affect staff or members of the public but do not have an impact on a client. Such incidents should be reported through other appropriate channels, including reports to Victoria Police or WorkSafe

Once an incident has occurred, the health, safety and well-being of the client and other involved parties are paramount. An appropriate incident response is critical.

This stage covers both the immediate response after an incident is identified or disclosed, as well as the ongoing support for the client.

CIMS: Immediate response

This involves ensuring the immediate safety, health and well-being of the client and other involved parties, obtaining medical attention, notifying Victoria Police and other emergency services as appropriate, preserving evidence, accessing specialist victim and support services as required and contacting the nominated key support person.

CIMS: Ongoing support

These responses involve supporting the client’s wellbeing by ensuring a safe and secure environment, whilst also providing and managing any rehabilitation, counselling or other support they may need in the future in response to the incident.

Particular types of incidents may require additional response actions to ensure the safety and well-being of the client. In particular, for all incidents that involve allegations of abuse. Abuse includes physical, sexual, financial or emotional/psychological abuse or neglect. Key actions required to respond to abuse are identified in this chapter and cross-referenced to allegations of abuse for further details where appropriate.

When an incident involves misconduct by a staff member to a child, service providers must consider requirements under the Reportable Conduct Scheme to notify the Commission for Children and Young People.

All actions should be undertaken in a way that is respectful of the person, culturally appropriate, and empowers them to make their own choices and decisions wherever possible, to the extent that the client is capable of making informed decisions. Some clients, such as those receiving disability services or children in any service, may have a key support person to support them (the client) in their decision-making (see section 2.2.3 Contact the key support person for a broader understanding of the key support person).

Actions taken by service providers in response to an incident should include the client, or key support person acting in the client’s interests, in the following activities:

  • ensure that timely and effective responses to client incidents address client safety and wellbeing
  • assuring the client that the incident will be taken seriously and dealt with in a fair and equitable manner
  • clearly educating clients about their rights and taking their wishes into consideration
  • identifying an advocate or key support person if appropriate, and keeping them informed throughout the process
  • ensure accountability of service providers to clients
  • keeping the client informed of the progress, outcome and any follow-up of incidents
  • involving the client in the process of reviewing or investigating the incident, including the opportunity to provide their account of what happened, with communication support if required
  • ensuring that personal and sensitive client information is appropriately managed and secured so as to mitigate the risk of privacy breaches.
  • ensure accountability of service providers to clients
  • protect and maintain the personal and sensitive information of clients, service provider staff, carers and others from whom a service provider collects personal information for the purpose of client incident reporting.

Flowlogic Integration with the Victorian DHHS Client Incident Management System (CIMS)

DHHS in Victoria are building a new system to manage client incident reporting and our FlowLogic system is using the API provided by the DHHS. This Client Incident Management System is commonly referred to as CIMS. DHHS have plans to allow external systems such as FlowLogic to communicate and transfer client incident data directly into CIMS.

The CIMS system is still in the beta testing. The originally scheduled launch date on July 1st, 2017 which was delayed until October 1st, 2017, and then delayed again until January 15th, 2018.

Overview of the CIMS stages

Process for responding to client incidents graph

Integration with the Victorian DHHS Client Incident Management System. References:

FlowLogic NDIS and Aged Care Data Management System

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About Christian Krauter

The Founder of Datanova, a visionary and digital business solution architect with 24 years experience in the rapidly expanding fields of information management systems, data governance and customer focused-strategy. Christian Krauter, is a recognised expert on analytical applications for Australian Government Services focused on improving client’s business results through cloud development, information management and data governance.