e-IRIS
Quality initiative by Even hospital
Public incident reporting
1
Incident Identification
Incident Date & Time
*
Department
*
Location
*
Classification of Incident
*
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2
Incident Classification
Incident Type
*
Select Incident Type
Clinical
Non-Clinical
Select Clinical or Non-Clinical to load the matching Category list
Category
*
Select Incident Type first
Specify Category
*
Required only when Others is selected.
3
Incident Details
Incident Description (what happened?)
*
0 / 4000
Correction / Immediate Action Taken
Probable Reason for Incident
Patient's Full Name | UHID
Optional
4
Supporting Evidence
Browse Files
Or drag and drop files here. Max
3
MB per file, 3.2 MB for all files together. Photos are resized automatically.
5
Reporter Details
Reporter Name
Optional
Department
Contact Number
Website
Clear Form
Submit Incident Report
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