(I) Event type |
(1) Problematic decision |
(2) Problematic execution |
(3) Problematic communication |
(4) Technical/mechanical malfunction |
(5) Insufficient information |
(II) Domains of medical care |
(1) Preventive medicine |
(A) Immunization |
(B) Preventive screening |
(2) Diagnostics |
(A) Medical history and physical examination |
(B) Tests |
(C) Reading, recording, and interpreting results |
(3) Treatment |
(A) Medications, blood products, fluids, diet |
(a) Ordering |
(b) Transcribing |
(c) Dispensing |
(d) Administration |
(B) Surgical and non-surgical procedures |
(a) Preparation |
(b) Procedure |
(C) Appointment scheduling, referral, and follow up communications |
(D) Other medical treatments |
(a) Psychiatric |
(b) Social services |
(c) Discharge planning |
(4) Patient monitoring |
(5) Patient communication |
(A) Preventive care |
(B) Diagnostic |
(C) Medication |
(D) Surgical care |
(E) Post-surgical care |
(F) Other medical treatment |
(6) Patient identification |
(7) Equipment |
(A) Equipment malfunction |
(B) Equipment availability |
(C) Use of equipment |
(8) Administrative |
(A) Medical record related |
(B) Other clinically significant administrative |
(III) Contributing factors |
(IIIA) Patient/child specific factors |
(1) Physical characteristics |
(A) Small size |
(B) Morphology |
(C) Varied size and morphology |
(2) Development |
(A) Physiological |
(a) Underdeveloped systems |
(b) Epidemiology |
(c) Growth |
(d) Child specific signs and symptoms |
(B) Cognitive, social-emotional |
(a) Ability to communicate |
(b) Ability to understand |
(c) Ability to control/regulate behavior |
(3) Minor legal status |
(A) Medical management |
(B) Decision making and consent |
(C) Confidentiality |
(D) Supervision |
(4) No contributing patient/child specific factor |
(5) Insufficient information to determine |
(IIIB) Human factors |
(1) Cognitive |
(A) Knowledge |
(B) Confusion |
(C) Assumptions |
(D) Inattention |
(2) Physical |
(A) Fatigue |
(B) Physical pain |
(C) Physical performance of a task |
(3) Emotional |
(A) Fear |
(B) Dislike |
(C) Emotional stress |
(4) None |
(5) Unclassifiable/insufficient information |
(IIIC) Latent conditions |
(1) Organizational systems |
(A) Systems for clinical communication |
(a) Across departments |
(b) Across professions |
(B) Systems of medication provision |
(a) Ordering |
(b) Preparing |
(c) Administration |
(C) Infection control systems |
(a) Hygiene |
(b) Prophylactic antibiotics |
(c) Infected clinicians/visitors |
(d) Evaluation |
(D) Systems of training |
(E) Systems for equipment acquisition and maintenance |
(2) Culture |
(3) Structure/framework of medicine |
(4) Physical environment design |
(5) Staffing |
(IV) Outcomes |
(IVA) The result of the problem |
(1) Near miss/good catch |
(2) Adverse drug event |
(3) Nosocomial infection |
(4) Cardiac arrest |
(5) Respiratory failure |
(6) Wrong treatment/procedure |
(7) Treatment of wrong patient |
(8) Wrong site surgery |
(9) Laceration |
(10) Excess bleeding |
(11) Loss of sensory input |
(12) Paralysis |
(13) Other neurological impairment |
(14) Organ system impairment |
(15) Fall |
(16) Burn |
(17) Fracture |
(18) Failed procedure |
(19) Breech of confidentiality |
(20) Adverse blood transfusion reaction |
(21) Patient missing |
(22) Unnecessary protective services involvement |
(23) Delayed growth/development |
(24) Disorientation |
(25) Loss of consciousness |
(26) Return to the ICU within 48 hours |
(27) Pain |
(28) Social disruption |
(29) None of the above but resulted in hospital |
(30) Admission or extended hospital stay |
(31) Death |
(32) Insufficient information to determine |
(IVB) Level of harm |
(1) Near miss, error did not reach the patients, no harm |
(2) Reached the patient, no harm |
(3) Emotional harm |
(4) Minor temporary harm |
(5) Major temporary harm |
(6) Minor permanent harm |
(7) Major permanent harm |
(8) Death |