Nitha became operational a year ago (March 2011). It is an information system aimed at supporting event analysis, which is required when a patient has or could have had serious healthcare-related injury. With the help of a standardised approach and this shared national knowledge base, patient safety is expected to increase.
Nitha has been developed by a project team composed of representatives from various counties, and municipalities have been involved in the project. A team of six county representatives are now managing the system at the Centre for eHealth in Sweden (CeHis).
"It is hoped that all counties will use Nitha by 2013. Currently, over 100 event analysis reports are stored on the system, and their number is increasing gradually," says Eva-Lena Ahlberg, Nitha project manager and a business developer at the patient safety department of Östergötland County Council.
Event analysis is a task that caregivers are required by law to undertake so as to improve patient safety. It consists firstly of differentiating incidents from adverse events. An incident is defined as an unexpected event that could cause injury. The term 'adverse event' is used if an injury did occur. For each event analysis activity, guidelines should state what type of events must be reported and documented in an incident report. The reason for deviations should be investigated and remedied, and the lessons learnt conveyed to the operational staff. If the incident is serious, a comprehensive investigation will be needed.
"Most of the time, an organisation's underlying weaknesses - e.g. the absence of checklists, difficulties in interpreting instructions - make something go wrong. Using the system [Nitha] reduces the risk of such events repeating themselves," Ms Ahlberg adds.
Nitha is operated in compliance with the methodology outlined in the document 'Handbook for patient safety. Risk analysis and event analysis' developed by the Swedish Association of Local Authorities and Regions - SALAR (Sveriges Kommuner och Landsting - SKL, in Swedish).
The Kronoberg County Council is one of the main users of Nitha. "It is good that the service has the same format as a guide. We do not need to learn a new approach," says Gunilla Karlsson, event analysis leader and business developer at the County Council. Ms Karlsson thinks Nitha makes her work easier because the data entered on the system (e.g. background knowledge) is automatically transferred into the event analysis report. But the system's biggest advantage, she believes, lies in the possibility for counties to participate in event analyses performed by other counties; this allows spreading knowledge and experience while learning from each other.
"Previously, we were using paper or local data files. Now, with the reports being gathered in a national database, we can check the underlying causes and find common solutions," Ms Karlsson adds.
Nitha has attracted much interest, not only from the Swedish counties, but also from municipalities and various agencies. "Many of them are interested in the Nitha event analysis support system," says Lars Jerlvall, eHealth strategist at CeHis. Mr Jerlvall adds that Nitha is being further developed and that one ambition for the future is to adapt it so that it supports risk analysis too.
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