Reporting an Adverse Event

1. Determine if the event meets the adverse event definition. See the list of definitions. The Resources web page has more guidance on definition.
2. Confirm that the adverse event is included in the list. Notify the Department of Health by completing and submitting the Notification Form. Staff will contact you to confirm the information listed on the form.
3. Optional: Complete the Contextual Information Form and submit it with the Notification. Facilities may want to provide more explanation to a reported event.
4. Conduct a root cause analysis (RCA) to determine the causes of the event. Use the RCA Process Guide to gather and review information.
5. Implement a corrective action plan for each adverse event consistent with the findings of the RCA.
6. Prepare the RCA report and include the corrective action plan. Remove any patient or staff identifiers.
7. Submit the completed RCA report by mail:

We do not recommend email for sending confidential information by email.

This guide outlines each step in detail: Process for Reporting an Adverse Event

 Forms

• Adverse Event Notification Form
  • Word fill-in form (83 KB)
  • PDF form (45 KB)
• Contextual Information Form
  • Word fill-in form (91 KB)
  • PDF form (39 KB)

Check-in Survey

The department implemented a quarterly check-in survey for facilities that do not have an adverse event to report. Facilities are asked to notify the department every three months whether or not they had an adverse event. The department emails the survey link to each facility 15 days after the end of each reporting quarter.

Facilities that do not have an event and do not complete the survey will be contacted. The department includes results of the check-in survey in the quarterly reports.

The survey has 3 questions and takes a brief moment to complete. To access the survey: Check-in Survey