INTERNAL NOTIFICATION SYSTEM TO IDENTIFY ADVERSE EVENTS

AN EXPERIENCE IN A TERTIARY HOSPITAL

Abstract

The study describes the implementation of an internal adverse event reporting system at Santa Casa de Misericórdia de Sobral, Ceará, focused on enhancing patient’s safety. The aim was to improve the hospital safety culture, furthering an approach based on continuous learning and transparency. Qualitative and descriptive methodologies were used, analyzing the transition process from a paper notification system to a digital system. To ensure engagement, ongoing training took place focusing on the importance of notification as a non-punitive element. The results indicated increasing notification rates and
improvement in the quality of communication between teams, enabling rapid interventions to reduce risks. Standardization and digitization of records facilitated real-time monitoring and data management, helping to identify patterns and critical areas. Initial resistance was overcome with awareness-raising actions and continuous feedback. The implementation of the system resulted in improvements in patient safety, demonstrating the effectiveness of a robust and participatory reporting system in promoting a safe hospital environment.