Table 2 Respondents’ comments on incident reporting considerations in the context of the case scenarios indicated
From: How do chiropractors manage clinical risk? A questionnaire study
Scenario 1. A patient with non-specific low-back pain has not improved at all after 4–6 treatments. | Scenario 2. A patient, who has a simple neck problem with no previous long-term problems, has now improved at least 80% and stayed at this level for a couple of weeks. |
‘It wouldn’t have occured to me to report it to CPiRLS, in a case of - “not responded to treatment” unless they had had a reaction to treatment” | ‘It makes no sense to me to stop treatment, apologise and report it to CPiRLS, which I consider more in the context of serious incidences and not lack of progress.’ |
‘There has been no incident why would one report to CPiRLS?’ | |
‘Report to CPiRLS but continue’ | |
Scenario 3. A patient returns from the last treatment with a new distal pain (e.g. sciatica when treated only for localized LBP, or brachialgia when treated only for local neck pain). | Scenario 4. An elderly woman complains about immediate chest pain on inspiration after manual treatment directed to her thoracic spine. |
‘The case might possibly be considered to be material for CIRLS.’ | ‘I would still report it to the CPiRLS - but would continue with treatment, I don’t feel they are mutually inclusive.’ |
‘I would report to CPiRLS if the exacerbation was significant and sustained, but would rarely apologise unless I was clearly at fault.’ | ‘I would report the event to CPiRLS but I would not apologise as this suggests I have done something wrong.’ |
‘I would only report to the CIRLS when I made a bad judgement or didn’t access the findings properly.’ | ‘If it’s only a broken rib, with no pulmonary complication, I would not think of reporting to CIRLS so far, but maybe in the future I will.’ |
‘I don’t see reporting an incident on CPiRLS as necessarily being linked with stopping treatment.’ | ‘If (the patient’s pain) is extreme, and would not get better within a few days, I would report it to the CIRLS. Otherwise I would not.’ |
‘I would be most likely to re-examine the patient and if I felt I was the most likely cause of the increase in symptoms I would report to CPiRLS’ |