Figure . Methods depend on the types of investigation. There are three levels of investigation for clinical safety incidents in the Victorian Health Incident Management System.(12) Literature review methods The published and grey literature about current HIT methods of incident investigation was reviewed. Bibliographic databases including Scopus, PubMed and Science Citation Index Expanded from January 2004 to May 2016 were searched. Only English language case studies and analyses of HIT incidents were included. After titular and abstract review, papers were selected for full review. Grey literature was identified by searching the websites of international patient safety agencies and programs such as the US Agency for Healthcare Research and Quality. A narrative synthesis was used to integrate findings into descriptive summaries. Relevant frameworks for studying the safety of HIT were also examined. Findings: Descriptive analysis of all investigations Our search identified 21 investigations of HIT incidents (Appendix A: Summary of the 21 studies investigating HIT incidents). Most of these were aggregate reviews of incidents from a broad range of clinical settings in six countries including the USA, UK, the Netherlands, China, Hong Kong and Australia (86%, n=18). About half (n=10, 48%) involved a range of HIT systems, 33% (n=7) were focused on medication management systems and one related to radiology information systems. Of the 21 investigations, three were in-depth reviews from inpatient settings in the USA. Of these, two related to medications management systems including order entry and bar-coding (13,14) and the other involved an image viewer to track patients in an Emergency Department.(15) Sixteen investigations examined patient outcomes (76%). In 15 of these, there were reports of patient harm and one case study related to a near-miss event (Appendix A: Summary of
Figure . Methods depend on the types of investigation. There are three levels of investigation for clinical safety incidents in the Victorian Health Incident Management System.(12) Literature review methods The published and grey literature about current HIT methods of incident investigation was reviewed. Bibliographic databases including Scopus, PubMed and Science Citation Index Expanded from January 2004 to May 2016 were searched. Only English language case studies and analyses of HIT incidents were included. After titular and abstract review, papers were selected for full review. Grey literature was identified by searching the websites of international patient safety agencies and programs such as the US Agency for Healthcare Research and Quality. A narrative synthesis was used to integrate findings into descriptive summaries. Relevant frameworks for studying the safety of HIT were also examined. Findings: Descriptive analysis of all investigations Our search identified 21 investigations of HIT incidents (Appendix A: Summary of the 21 studies investigating HIT incidents). Most of these were aggregate reviews of incidents from a broad range of clinical settings in six countries including the USA, UK, the Netherlands, China, Hong Kong and Australia (86%, n=18). About half (n=10, 48%) involved a range of HIT systems, 33% (n=7) were focused on medication management systems and one related to radiology information systems. Of the 21 investigations, three were in-depth reviews from inpatient settings in the USA. Of these, two related to medications management systems including order entry and bar-coding (13,14) and the other involved an image viewer to track patients in an Emergency Department.(15) Sixteen investigations examined patient outcomes (76%). In 15 of these, there were reports of patient harm and one case study related to a near-miss event (Appendix A: Summary of