Incident report training

1. Incident Reporting
A GUIDE ON How To Report Incidents

2. What’s an “Incident”?
An “Incident” is when any adverse event happens that affects a patient, guest, or staff member Incidents
are classified as one of the following:
• Reportable Event: A reportable event is one that the State requires you reporting in a specific time frame.
• Sentinel Event: An unexpected event that results in a patient/client death OR a serious physical or
psychological injury.
• Critical Event: An event with a significantly high impact, consequence, and/or effect on operations, staff,
or patients. Critical events are abrupt, powerful events that fall outside the range of normal functions. This is
not to be confused with a Sentinel Event.
• Non-Critical Event: An event unanticipated or outside normal operations, for which the Organization has
strategies and procedures in place to manage with little or no external assistance from first responders or
the general community.

3. What is a Reportable Event?
A Reportable Event is that in which your State mandates must be reported to a specific State
department within a certain time frame. Not reporting the event could lead to fines,
investigation, or potentially closure. Click the link on your state to see the guidelines.
Texas Colorado New Jersey Utah
Florida Arizona Massachusetts Pennsylvania
California Ohio Tennessee New Mexico
North Carolina Alabama Connecticut Delaware
Georgia Illinois Wyoming Nevada

4. What is a Sentinel Event?
Sentinel Incidents are defined as:
• An unexpected occurrence involving death or serious physical or psychological injury, or the risk
thereof. Serious injury specifically includes loss of limb or function. The phrase“or the risk thereof”
includes any process variation for which a recurrence would carry a significant chance of a serious
adverse outcome.
• Any serious bodily trauma received by a patient or staff member as a result of treatment or a work
related activity that requires immediate medical or surgical evaluation or treatment in a hospital
emergency department to prevent permanent damage or loss of life.
• Such events are called “sentinel” because they signal the need for immediate investigation and
response.
• The terms“sentinel event” and “error” are not synonymous; not all sentinel events occur because of
an error,and not all errors result in sentinel events.

5. What is a Critical Event?
• AS A GENERAL RULE, A Critical Incident includes any time that paramedics, police, or any other
emergency personnel are contacted to come to your facility for a patient or staff injury.
• A Critical Incident could also includes an event that occurs that causes a cease in the normal
functions of daily operations. Examples could be an extended power outage, the breaking of the
HVAC system, etc.
• Non-Critical Incidents are all other incidents that occur at the facility that are neither Reportable,
Sentinel, or Critical.
• Why are Non-Critical Incidents important to report?
• Just because an event or incident does not result in a death or serious injury, doesn’t mean it
shouldn’t get reported. These types of incidents could be small issues now, however, if not
corrected could turn into a devastating incident at your facility.

6. WHAT ARE EXAMPLES OF REPORTABLE, SENTINEL, AND
CRITICAL INCIDENTS?
❒ *Death of a patient while Admitted:
❒ Accident
❒ Homicide
❒ Suicide
❒ Undetermined/Unknown Reason
❒ Death of a patient w/in 30 days of D/C
❒ Medical problem/911(Seizures, Fainting, Psychiatric Emergencies)
❒ Attempted use of a Weapon
❒ Significant Theft/Vandalism to Property
❒ Elopement (Only Inpatient)
❒ Significant Injury to patient (911)
❒ Sexual Abuse/Battery (w/in 12 months)
❒ Bomb/Biological/Chemical Threat
❒ Hepatitis B/C/HIV Positive
❒ Death of an Employee/Visitor on site
❒ Drugs found in residence (Only Inpatient)
❒ Medication Error Resulting in 911
❒ Security Incident - Unintentional
❒ Suicide Attempt/Suicidal Behavior
❒ Employee Arrest
❒ Employee Misconduct
❒ Riot/Hostage Situation
❒ Significant Injury to Staff
❒ Problematic event that may
lead to a media report
❒ Refusal to 911/Hospital
❒ Abuse to patient
❒ Infectious Disease Reporting
❒ Utility/Major Equipment Failure (Significant
enough to cease operations)

7. Non-Critical Incidents
• Less than Critical Incidents are all other incidents, and include but are not limited
to:
• Property Loss or Damage
• Vehicular Accidents that do not result in harm to patients or staff
• Threats or verbal altercations
• Trespassing
• Rule Violations
• Medication Errors that do not result in harm to the patient

8. WHAT ARE EXAMPLES OF NON-CRITICAL EVENTS?
❒ Altercation/Verbal
❒ Property Damage/Loss
❒ Breach of Security
❒ Administrative D/C
❒ Altercation/Physical
❒ Contraband/Paraphernalia
❒ Vendor/Visitor Injury
❒ *Rule Violation
❒ Violent Action:No Injuries/Damage
❒ Vehicular Accident (No Injury)
❒*Procedural Break
❒ *Weapon Found
❒ Violent Threat/Others
❒ *Employee Injury (All)
❒ Equipment/Utility Issue (does not interfere
with normal operations)
❒ Other: SUP ONLY
❒ *Suicidal Thoughts/Ideations
❒ General Medical (non 911)
❒ Patient left AMA/ATA
❒ Near Miss

9. Sentinel Event: DEATH
• When a patient’s life terminates while receiving services, during an investigation. All deaths should be
reported as:
• (a) Accident. A death due to the unintended actions of one’s self or another.
• (b) Homicide. A death due to the deliberate actions of another.
• (c) Suicide. The intentional and voluntary taking of one’s own life.
• (c) Unexpected. Natural or UnNatural
• (d) Undetermined. The manner of death has not yet been determined.
• (e) Unknown. The manner of death was not identified or made known.
Note: If we are made aware of a death of a patient that has discharged within the last 30 days, this is a Critical event.

10. Reportable Event: ELOPEMENT
• Elopement Is “The unauthorized absence of any individual [from a] . . . licensed
substance abuse . . . program.”
• AKA “Jumping the Fence” or “AWOL”
• If a patient cannot be found for more than four hours of the treatment day

11. Critical Incident:
MEDICAL PROBLEMS AND MEDICATION ERRORS
• Medical problem/911(Seizures, Fainting, Psychiatric Emergencies): Any incident that requires us
to call 911 due to a medical issue.
• Medication Error Resulting in 911: Any Medication Error that occurs in which the Medical staff
determine that it is necessary to call 911. This will need to be documented even if the patient
refuses to go to the hospital.

12. Critical Incident: REFUSAL TO 911
• Refusal to 911/Hospital: Any patient that refuses 911/Hospitalization a Medical or Clinical staff
member recommends

13. REPORTABLE EVENT: INFECTIOUS DISEASE CONTROL
HEPATITIS B CONVERSION/HIV POSITIVE
• Hepatitis B Conversion: Any patient that tests positive for Hepatitis B or C.
• When a patient’s labs come back positive for either Hep B OR Hep C, this must be reported immediately to Compliance.
• Compliance has one week to submit this information to the State.
• HIV Positive: When a patient’s bloodwork comes back as HIV positive.
• Infectious Disease Reporting: Each State will have guidelines as to what Infectious Diseases are reportable. Please be clear on the Incident Form, to
describe which infectious disease/s in which the patient came up positive.
• How do I report a case of acute HIV?
• Call your local reporting authority within one working day.
• How do I report non-acute HIV or AIDS cases among adults or adolescents ages 13 and older?
• Submit a completed form to your local reporting authority, or call them as soon as you receive the information.
• The Goal here is to STOP the Spread of Infection!

14. REPORTABLE EVENT: INFECTIOUS DISEASE CONTROL
HEPATITIS B CONVERSION/HIV POSITIVE
What information should be included on the Adult HIV/AIDS Confidential Case Report Form?
• Demographics
• Residence at diagnosis
• Facility at diagnosis
• Personal history
• Lab tests
• Clinical status
• Medical treatment
• Testing and treatment history
Where can I get copies of the Adult HIV/AIDS Confidential Case Report Form?
Due to concerns about potential for misuse, HIV/STD reporting forms are not available on this website.
To obtain this form, contact your local reporting authority.

15. Critical Incident: USE OF A WEAPON
• Weapon (Attempted use of): If anyone on premises is in possession (either allegedly or confirmed) of a
weapon.
• An act from outside an organization that bypasses or contravenes security policies, practices, or
procedures. A similar internal act is called security violation.

16. Critical Incident: THEFT OR VANDALISM
Significant Theft/Vandalism to Property:
• Any theft/vandalism that interferes with daily operations.

17. Critical Incident:
EMPLOYEE ARREST OR MISCONDUCT
• Employee Arrest: Any arrest of an employee is considered a Critical Incident.
• Employee Misconduct: Work-related conduct or activity of an employee that results in:
• death or harm to a patient;
• abuse, neglect or exploitation of a patient; or results in a violation of statute, rule, regulation, or
policy.
• This includes, but is not limited to:
• misuse of position or state property;
• falsification of records;
• failure to report suspected abuse or neglect;
• contract mismanagement;
• or improper commitment or expenditure of state funds.

18. Critical Incident:
SECURITY INCIDENTS, OR A RIOTS/HOSTAGE SITUATION
• SECURITY: An unintentional action or event that results in:
• compromised data confidentiality, a danger to the physical safety of personnel, property, or
technology resources;
• misuse of state property or technology resources;
• and/or denial of use of property or technology resources.
• RIOT/HOSTAGE: Human acts that jeopardize the health, safety, or welfare of patients such as
kidnapping, riot, or hostage situation.

19. Reportable Event:
SEXUAL ABUSE OR SEXUAL BATTERY
ANY unsolicited or non-consensual activity by one patient to another patient, a staff member, or other
individual to a patient, or a patient to a staff member regardless of the consent of the patient.
This may include:
• Sexual battery as defined as “oral, anal, or vaginal penetration by, or union with, the sexual organ of another or the anal or
vaginal penetration of another by any other object; however, sexual battery does not include an act done for a bona fide
medical purpose.”
• Any willful or threatened act or omission that causes or is likely to cause significant impairment to a vulnerable adult's
physical, mental or emotional health. This act of Abuse can be done by either a staff member or another patient.
This includes any unsolicited or non-consensual sexual battery by one patient to another patient, a service provider
employee or other individual to a patient, or a patient to an employee regardless of consent of the patient.

20. SUICIDE ATTEMPT
• A suicide attempt is a potentially lethal act which reflects an attempt by an
individual to cause his or her own death as determined by a licensed mental
health professional or other licensed healthcare professional.
• Depending on your State reporting requirements, a suicide attempt that results in
a serious injury or severe harm is more than likely a Reportable Event.
• While a suicide attempt that does not result in injury or harm is more than likely a
Critical Incident.
• Get to know what your State requirements are.

21. Finding a weapon at the Facility
If you happen to find a gun at the facility. Do not touch it, do not unload
it, do not let ANYONE near it.
Immediately walkie-talkie your supervisor with the correct Emergency
code. Do not panic.
If there are patients in the area, have a fellow staff member take them
to a different area while you wait for your supervisor.

22. Incidents & Events: SUMMARY
• If any of these incidents happen, your first goal should always be to ensure
everyone’s safety, and then call emergency services if necessary.
• If you are not sure what kind of Event or Incident occurred - ASK your Supervisor
immediately.
• If you are not sure whether or not an Event or Incident should be documented -
ASK your Supervisor.
• Remember that the end goal is the physical and psychological safety of both the
patients and the staff.

23. POLICY: Every Incident MUST be reported
IN A TIMELY FASHION
• Assess the situation first. If it is an emergency, contact the appropriate authorities.
• If the Incident is CRITICAL, REPORTABLE, OR SENTINEL: Report the Incident via phone call with the
Facility or Operations Director and the Compliance Team. Please attempt to submit the form within the hour.
If the Incident requires your full attention, please submit the report as soon as the situation, the patients, and the
starr are safe.
• If it is NON-Critical, you have 24 hours to submit the Incident Report.
• Fill out the Incident Report. Be as detailed as possible in your reporting of the Incident, and fill out
each question/box entirely. Use facts, NOT opinions. If you have multiple people and departments who
were witness to/involved in the Event, try and piece together an accurate timeline and submit that in ONE
Incident Report.
• Remember to use specific staff names when reporting. Get their Witness Statement as soon as possible.

24. POLICY: Every Incident MUST be reported!
As important as it is to know what to do is, it is even more important to know what not to do.
• DON’T offer to pay all medical expenses
• DON’T transport injured guests
• DON’T admit responsibility
• DON’T mention insurance
• DON’T argue or debate causes of accident
• DON’T reprimand employees at the scene
• DON’T discuss with unauthorized people - EVER

25. POLICY: Every Incident MUST be reported!
• To ensure that our facilities properly respond to all incidents, the
reporting policy must be followed.
• Keep in mind that, if you see any of the following Incidents occur,
you must first ensure that all parties involved are safe and then
contact any appropriate emergency services, and then you must
contact the Supervising staff member on duty and file an incident
report.

26. Incident Reports: HOW TO SUBMIT
Please submit all Incident Reports through the Compliance platform.

27. Don’t Forget about reporting Near Misses…
Reporting a Near Miss, aka “Good Catch” is crucial to discovering any potential threats.
If you are in a position where something ‘almost’ or ‘could have’ occurred, it’s important
to complete a Near Miss form. This will communicate any need for improvement in your
facility’s processes, procedures, or ways of communicating.
Your feedback as a staff member could potentially save lives! You can find the Near Miss
form under the ‘Communication’ tab.

28. SUMMARY
• All Incidents must be reported and documented through the Incident Reporting Process. The
Incident Report data is utilized to recognize trends and to ensure, and improve, the safety of
staff and patients.
• If you have any questions, do not hesitate to ask your Supervisor.
• When in doubt, your first priority should be the health and safety of the patients, your fellow
staff members, and yourself (in some cases, this will require you calling emergency services).