C
L
I
N
I
C
A
L
|
Serious |
Major |
Moderate |
Minor |
Minimum |
Patients with Death unrelated to the natural course of the illness and
differing from the immediate expected outcome of the patient management, including:
- Patient absconded from full-time medical care without obtaining consent to leave the hospital,
resulting in death (suicide or murder) or major permanent loss of function.
- Perinatal death of infanting with a birthweight ≥ 2,500gm unrelated to congenital causes.
- Violence, murder, or other criminal activity causing dealth or major permanent loss of function to
a patient
- Patient fall resulting in death or major permanent loss of function as a direct result of injury
after the fall.
- Fire caused by medical equipment supplied by the equipment company to allow the patient to have oxygen
therapy at home, which resulted in in major patient injury or death.
- Outpatient surgery at which cardiac arrest occurred, resulting in death or permanent injury to the patient.
or
any of the following Sentinel Events:
- Procedures involving the wrong patient or body part
- Suicide
- Retained instruments
- Unintended material requiring surgical removal
- Intravascular gas embolism resulting in death or neurological damage
- Hemolytic blood transfusion
- Medication error leading to death
- Maternal death or serious morbidity associated with labor or delivery
- Infant abduction or discharge to wrong family
- Requires notification under existing legislative reporting requirements
|
Patients with Major permanent loss of function (sensory, motor, physiologic or
psychologic) unrelated to the natural course of the illness and differing from the
expected outcome of patient management
or any of the following:
- Disfigurement as a result of the incident
- Absconded involuntary mental health patient
- Threatened or actual physical or verbal assault of patient or staff requiring
intervention
|
Patients with Permanent reduction in bodily functioning (sensory, motor, physiologic, or
psychologic) unrelated to the natural course of the illness and differing from the
expected outcome of patient management
or any of the following:
- Increased length of stay as a result of the incident
- Surgical intervention required as a result of the incident
|
Patients requiring increased level of care including:
- Review and evaluation
- Additional investigations
- Referral to another clinician
|
Patients with No increased level of care or length of stay.
This group can be subdivided so that
patients with No harm can be identified separately .
|
C
O
R
P
O
R
A
T
E |
Staff: Death of staff member related to work incident or suicide, or hospitalization
of 3 or more staff
|
Staff: Permanent injury to staff member, hospitalization of 2 staff, or lost time
or restricted duty or illness for 3 or more staff or pending or actual WorkCover
prosecution
|
Staff: Medical expenses, lost time or restricted duties or injury / illness for
2 or more staff
|
Staff: First aid treatment only with not lost time or restricted duties
|
Staff: No injury or review required
|
|
Visitors: Death of visitor or hospitalization of 3 or more visitors
|
Visitors: Hospitalization of up to 2 visitors related to the incident / injury
or pending or actual WorkCover prosecution
|
Visitors: Medical expenses incurred or treatment up to 2 visitors not requiring
hospitalization
|
Visitors: Evaluation and treatment with no expenses
|
Visitors: No treatment required or refused treatment
|
|
Services: Complete loss of service or output
|
Services: Major loss of agency / service to users, including cancellation of booked
surgery more than twice
|
Services: Disruption to users due to agency problems
|
Services: Reduced efficiency or disruption to agency working
|
Services: No loss of service
|
|
Financial: loss of assets replacement value due to damage, fire etc > $1M or loss
of cash / investments / assets due to fraud, overpayment or theft >$100K
|
Financial: loss of assets replacement value due to damage, fire etc $100K-$1M
or loss of cash / investments / assets due to fraud, overpayment or theft $10K-$100K
|
Financial: loss of assets replacement value due to damage, fire etc $50K
to $100K or loss of cash / investments / assets due to fraud, overpayment or theft
to $10K
|
Financial: loss of assets replacement value due to damage, fire etc to $50K
|
Financial: No financial loss
|
|
Environmental: Toxic release off-site with detrimental effect. Fire requiring
evacuation
|
Environmental: Off-site release with no detrimental effects or fire that grows
larger than an incipient stage
|
Environmental: Off-site release contained with outside assistance or fire
incipient stage or less
|
Environmental: Off-site release contained without outside assistance
|
Environmental: Nuisance releases
|