Health care quality management by means of an incident report system and an electronic patient record system.

Background: Quality management in health care services has not been as successful as in other industries.

Objective: To assess the potential contribution of an on-line incident reporting system (OIRS) and of an electronic patient record (EPR) system to quality management in hospitals.

Methods: The two approaches are being implemented in Osaka University Hospital.

Results: Analysis of the early use of the on-line reporting system indicates that this qualitative approach has been effective to avoid adverse medical events. The quantitative methodology with the EPR is still in the phase of developing.

Conclusion: Direct data entry by medical staff and an EPR based on dynamic templates and a dynamic problem oriented approach could be useful for building clinical data repositories that can support clinical quality management.