1. Patient Safety Reporting Process
Pursuant to the Patient Safety Act of 2005 this document is privileged and confidential patient safety work product and may not be disclosed.

2. Entering a Patient Safety Report
Definition of an Incident – Any occurrence that has produced an actual, potential, or perceived injury, or any practice, situation, premise, or product defect that, in the observer’s opinion, may produce an injury if left uncorrected. (Core Policy 01.30)
When an event meets the above definition, then a Patient Safety Report must be completed. If in doubt, complete a patient safety report.
Who puts in an event: Any staff member that has witnessed or is involved with a patient actual or potential incident. Physicians, Residents, ARNP and PA’s can also report an incident.
How soon do I need to report the incident after it occurred: You need to report the incident immediately or as soon as you can. By law all incidents must be reported and reviewed by a Risk Manager/Designee within 3 business days.
Where do I report the incident: All incidents will be reported through the Shands HealthCare intranet. It can be found on the home page.

3. Flow of the Patient Safety Report Process
The Patient Safety Report System is task driven.
Event Reported
The Clinical Risk Management Department reviews the reported events and looks for potential serious reportable events
notification is sent to manager of Unit/Dept where event happened.
Note: Risk Managers or your unit manager may come to you later with some questions regarding the incident to help clarify the cause/actions related to this event.
Manager investigates and follows-up as appropriate. They are responsible for assigning a cause and action if needed.
Done

4. Report a new event – log in to the Shands portal and click “Patient Safety Report – UF&Shands”

5. Select “Report an Event”

6. Select your site and identify your job position as noted below.
Site will default to UF&Shands
Select Job Position and click on “Next” button when Job Position selected
“Next” button is located under this list – when the list collapses you will be able to view it.

7. Next, this screen will appear where you will select a category that best describes the event.

8. Select the appropriate subcategory:
Do not hesitate to click on all categories to see what they include. This is how you will familiarize yourself with the content and it won’t hurt anything.
For events that do not pertain to a patient, please use the “Non Patient” category. This includes visitors, students, and volunteers.

9. Enter the event.  Fields in red are mandatory - missing fields will be flagged with “!” sign.
Enter date of event format mm/dd/yyyy like 05/05/2012. (You can also browse for the date by clicking on the calendar.) 
Time field is in military time. Do not enter colon “:” character.
Select the unit where the event occurred by pressing on the field box or on [ ...] button.
To select the right patient, enter the MRN# or the last name and then select “Search”. A list of matching patients will appear. Select the appropriate patient and date of admission.
Enter the event description. Provide a brief, factual description of the event. Do not include subjective comments or opinions.
The final step before completing the first screen is to assign a severity category. The severity is related to the extent of injury to the patient. Pick the one that you think is best.
Select for definition
Select “Next” to go to the next screen. They system will guide you through the rest of the submission process.
Pursuant to the Patient Safety Act of 2005 this document is privileged and confidential patient safety work product and may not be disclosed.

10. Other Important Information
Enter all persons who can “Speak to the Event”
under the section “Other Involved Parties”.
If you get interrupted at any time, press the “Save and Hold” feature. You must come back and complete the form within 12 hours.

11. Enter all persons who can “Speak to the Event”
Once you select “Employee” you must use the search button to find the employee’s name.
Pursuant to the Patient Safety Act of 2005 this document is privileged and confidential patient safety work product and may not be disclosed.

12. Final Notification for Event Reporting
When you have successfully completed the form, this screen will appear.

13. Serious Events / Adverse Patient Outcomes
For Serious Events and/or an event that involves an Adverse Patient Outcome, please call the Clinical Risk Management Department at

14. Questions
You can always ask your manager first and they can answer most of your questions.
If you have any questions, please call the Clinical Risk Management Department at for assistance.

15. You should be fully prepared to enter an incident report into the Patient Safety Reporting System
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