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Requesting the Use of Patient Safety HERO and SCA Data for Purposes of Research

August 2019

What is HERO?

HERO is “Hopkins Event Reporting Online,” an online portal for any Johns Hopkins Health System employee to report potential or observed situations which have, or may in the future, caused harm to patients or staff. HERO collects information about safety concerns, events, or near-misses as reported by employees.

What kinds of data can HERO provide?

The HERO reporting system has been active since December 2015. Data sets pulled from HERO capture details included in event reports including the event type (e.g., “Healthcare IT”, “Lines, Drains and Access”, “Surgery/Procedure”), location(s) where the event occurred and the people involved, and narrative details.  The majority of HERO data requests are for information regarding specific event types in specific locations.

Are there any challenges or limitations to using HERO data?

Events entered in HERO have been voluntarily reported. This means that not every safety event that occurs will be included in the HERO data set. Event reporting rates are impacted by many confounders and current literature suggests that 40-90% of safety events are NOT reported. When using data sets from HERO, it is important to note that increases and decreases in the number of event reports is not a reliable way to indicate whether an area has become more or less safe.

What is the SCA?

The SCA is the “Safety Culture Assessment,” an overall activity designed to assess the safety culture in a given work area. The SCA aggregates results from several validated surveys to provide a “snapshot” of how employees perceive patient safety and quality in their local work area. In accordance with The Joint Commission’s recommendations, the Patient Safety Department for the Johns Hopkins Health System manages the administration of this assessment every 18 months in inpatient and ambulatory locations, ambulatory surgery centers, home care, and Johns Hopkins Community Physicians.

What kinds of data can the SCA provide?

Safety Culture data has been collected in some form at JHM for over ten years, however, The SCA utilizes several different validated surveys and questionnaires to determine aggregate scores in domains such as Teamwork Across Units, Exhaustion and Resilience, Perceptions of Local Management, and Communication Openness. There are 21 individual domains included in the SCA. These scores can be calculated at the unit, department, and entity levels, as well as for medical office locations and ambulatory locations. The majority of SCA data requests are for information regarding unit or departmental-level scores.

Are there any challenges or limitations to using SCA data?

In order to protect respondent anonymity, scores cannot be returned for respondent groups that have fewer than five respondents or fewer than five responses. Safety Culture Assessment data has been collected since 2015, however, due to survey content changes, area moves, staff turnover, changes in local and senior management, and the time between survey administrations, it remains difficult to assess changes in SCA scores over time.

Am I required to obtain approval from the Patient Safety Department before using this data for research purposes?

Yes. If the eIRB application indicated that HERO or SCA data will be used as a data source, the submission must be accompanied by written approval from a member of the Patient Safety Department. Depending on the data being requested and what it is being requested for, there may be additional approvals required from departmental or entity data stewards prior to approval from Patient Safety. Some requests may also necessitate a review by the health system’s Risk Management department. If this is the case, the Patient Safety Department will work with you to obtain these separate approvals and reviews.

Why am I required to obtain approval before using this data?

Patient safety data, such as from HERO or the SCA, is considered “peer review privilege protected” which means that provided it is handled in the correct way and in accordance with any state requirements, this data cannot be considered discoverable evidence in a legal proceeding. If this data is used outside of these protections, it puts Johns Hopkins Medicine at risk for potential litigation. The approval process is necessary to ensure the data will not be used in ways that will waive these protections.

Who do I contact if my study requires the use of HERO or SCA data?

To request the use of HERO or SCA data prior to your IRB submission, please complete the online request form: https://jhmi.co1.qualtrics.com/jfe/form/SV_cxdp1YRMRoqsDNr

If you have any questions regarding the use of HERO or SCA data please contact hero@jhmi.edu

Are there any costs for obtaining HERO and SCA data?

The Patient Safety department will do everything possible to support research. Although every effort is made to avoid adding cost or inconvenience to research protocols and projects, there may be some scenarios where the size and complexity of a data report and the task of data cleaning exceed the available resources. In some cases, the Patient Safety department may wish to meet with the study team to discuss potential funding.