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MFP Quality Assurance and Critical Incidents

What is a Critical Incident

A serious or traumatic event which causes, or is likely to cause, physical and/or emotional distress, risk or change in health and well-being to the MFP participant

Why are Incidents Reported?

What Incidents Must Be Reported for MFP?

Incident Review Form (M)

Policy for Reviewing and Reporting Incidents (for MFP participants already transitioned to the community)

MFP Incident Review Policy

DRAFT Reviewed on July 7, 2010

UIC will conduct a review on each critical incident for transitioned MFP participants. If UIC were to learn that a critical incident occurred for a participant, but no incident report was submitted by the TC, then UIC would contact the TC and copy the TC Supervisor, department/division leads to facilitate completion of the incident report and the review process. Aggregate summaries will be completed every six months and reported to CMS. Action plans will be developed.

Incident Reporting: General Procedure*

  1. TC begins investigation process by interviewing all involved parties and reviewing available materials to determine the cause/effect of the critical incident
  2. TC should notify their supervisor and their UIC contact that an incident has occurred. A critical incident review conference call should be scheduled within 5 business days of the critical incident.
  3. TC will complete informational sections of critical incident report (Form M) in the online documentation system. TC can provide additional details on the investigation process in the notes system.
  4. TC and agency supervisor conduct an internal review and agency supervisor completes the “Internal Review” section of the critical incident report.
  5. The critical incident review conference will be conducted with TC, TC supervisor, agency leads and UIC pod leaders. This will be set up by the UIC pod leader. Recommendations for changes to the mitigation plan may be made.
  6. UIC will complete the external review section of the critical incident report, summarizing the incident review and recommendations.
  7. UIC will conduct a 30 day follow-up call to the TC to determine the success of the updated mitigation plan.

* The incident reporting process may vary slightly by Div/Dept. Contact your UIC pod leader for clarification if you have questions or concerns about this process.

More About Critical Incidents

Incident Investigation

An investigation of a critical incident should be conducted (a) in response to a report of an incident (b) in reaction to a finding of a critical incident identified during routine monitoring. An investigation is a method for uncovering or otherwise identifying the facts of a potential critical incident and then documenting what you have found.

The investigation needs to be unbiased, fair, and in keeping with due process guidelines. In the course of an investigation, it is important to balance the need to protect vulnerable participants with the requirements of the program.

Purpose of Investigation

The goals of an investigation are:

  1. Obtaining accurate information about the alleged critical incident.
  2. Adhering to due process and fairness, and
  3. Balancing the need for the:

Essentially an investigation seeks to answer traditional 'journalist's questions.'

Investigation Methods

Once you know what information you’re looking for, there are countless methods that can be used to prove or disprove a report of a critical incident or determine compliance with the mitigation plan. Some of these include: While all of these methods may be used in conducting an investigation, the three most common methods used in critical incident investigations are: These three methods enable you to collect the most comprehensive and immediate data about an incident. Data collected by these methods can also be corroborated by the other methods listed above.

Documentation

Finally, any investigation is only as good as the documentation of the information collected. No matter how well you collect information, documenting what you find in a concise, fair and factual manner is essential to the success of the effort. This is equally important whether you are conducting a routine investigation of minor incident or investigating a serious incident involving jeopardy to the participant. Every document you create, every note you take, every report you file has the potential of becoming evidence in a hearing or court action.

Adapted from Source: National Association for Regulatory Administration and the Muskie School of Public Service © 2008