Healthcare professionals

Do's and don'ts

Situation A. Open disclosure > Don'ts


Situation A. Open disclosure > Do's



Situation B. Support for the second victim > Don'ts


Situation B. Support for the second victim > Do's



Situation C. Crisis communication > Dont's


Situation C. System approach to preventing distractions > Do's



BACRA: A web tool to analyze safety incidents and search for solutions

What is BACRA (Basada en Análisis Causa RAíz - Based on Root Cause Analysis) and what are its characteristics?

  • It is a web tool that strives to facilitate analysis of safety incidents by middle managers and first-line health professionals as well as establishing a series of measures to implement to prevent their recurrence. 
  • It incorporates part of the protocols of incident analysis based on the Harvard study, analysis of the 5 Whys (a characteristic of root cause analysis), the prioritization of risks used in modal analysis of failures and effects, and the matrix employed in the improvement plan tool (PDCA).
  • It is not a resource that substitutes reporting systems–instead, it is complementary to them.
  • It does not require specific training to be used.
  • Facilitates analysis of the incident by a small group of professionals (3-5 persons).
  • Permits analyzing the incident in less than 20 minutes.
  • Contemplates the nature of specific harm taking place at hospitals and primary care centers.
  • Makes the identification and differentiation of latent and immediate causes of the incident possible.
  • Ensures privacy and confidentiality of the information.
  • Offers full guarantees for legal safety of the professionals (the platform does not require entering any personal data or logins). The analysis remains encrypted by the password chosen by the professional/s carrying out the analysis.
  • It involves middle managers in the search for solutions.
  • It is focused on the search for solutions to prevent the same incident from reoccurring.
  • It helps to implement solutions and to check whether the expected result is obtained.
  • The final product is a matrix that includes identified causes, risk priority number (RPN), actions to implement, those responsible, dates, and follow-up measures (indicators).


For further information on BACRA:

Carrillo I, Mira JJ, Vicente MA, Fernandez C, Guilabert M, Ferrús L, et al. Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead The Search for Solutions to Patient Safety Incidents . J Med Internet Res. 2016;18:e257.