Introduction
Purpose
The purpose of the UNC Adams School of Dentistry (ASOD) Online Incident Form is to connect appropriate points of contact, maintain records of incidents that occur at UNC ASOD, while also automating the process to include instructions for next steps, notifying appropriate individuals or departments, and improving communication practices.
Scope
Use of the Online Incident Form is the responsibility of all ASOD personnel, including faculty, adjunct, staff, residents, students, and affiliates (i.e., interns, volunteers, and visiting scholars).
Online Incident Report Description
Online Incident Report (https://bit.ly/asod-incident-report) is to be utilized whenever an incident or event occurs that may or may not have caused injuries to a person, damaged organizational assets, or impeded providing treatment. Some examples of this can include, but not limited to, adverse reactions to equipment or material, falls, burns, improper treatment, medical emergency, broken instrument, and swallowed object. Access to the Online Incident Report (https://bit.ly/asod-incident-report) is unrestricted and can be completed from any mobile device, to ensure information and guidance is provided expediently.
Procedure
Initial Submission
As soon as realistically possible, but no later than 24-hours after a reportable incident occurring, an ASOD personnel or their designee must submit an Online Incident Report (https://bit.ly/asod-incident-report), to minimize response time. Once the form has been accessed, follow the guided steps and provide the necessary information which includes an email address, the incident type, location of the incident, and incident details. After the Online Incident Report (https://bit.ly/asod-incident-report) is submitted, a confirmation email will be sent to both the reporting individual and the incident location point of contact, with an Incident ID number and a detail summary.
Post Submission
Depending on the incident type, additional actions may be required to receive the appropriate care. If this occurs, a follow up email will be sent to the reporting individual with, but not limited to, guidance on next steps, maps, additional forms, and/or an appropriate point of contact. Additionally, the appropriate UNC facility (i.e., Occupational Health [UEOHC], Campus Health, UNC Hospital Phlebotomy Lab, ASOD Human Resources, and/or ASOD Preceptor) is automatically notified, to provide additional assistance, if applicable.
Documentation & Corrections
If any documentation is generated (i.e., Medical Emergency Report) or corrections need to occur, send an email request to ASOD_ClinicalCompliance@unc.edu with the Incident Report ID (if known), date of incident, and what needs to occur. Modification and access to the master list is restricted, due to the sensitive nature of the content.
Related Requirements
External Regulations and Consequences
Unit Policies, Standards, or Procedures
Contact Information