9/12/2023 0 Comments Define sentinel events![]() ![]() One or more of the following must be present to determine that it is a sentinel event: ![]() Rape, assault (leading to death, permanent harm, or severe temporary harm), or homicide of any patient receiving care, treatment, and services while on site at the hospital [Sexual abuse/assault (including rape) as a sentinel event is defined as nonconsensual sexual contact involving a patient and another patient, staff member, or other perpetrator while being treated or on the premises of the hospital, including oral, vaginal, or anal penetration or fondling of the patient’s sex organ(s) by another individual’s hand, sex organ, or object.Hemolytic transfusion reaction involving administration of blood or blood products having major blood group incompatibilities (ABO, Rh, other blood groups).Any elopement (that is, unauthorized departure) of a patient from a staffed around-the- clock care setting (including the ED), leading to death, permanent harm, or severe temporary harm to the patient.Abduction of any patient receiving care, treatment, and services.Discharge of an infant to the wrong family.Unanticipated death of a full-term infant.Suicide of any patient receiving care, treatment, and services in a staffed around-the- clock care setting or within 72 hours of discharge, including from the hospital’s emergency department (ED).If, during the course of conducting survey activities, a potential serious patient safety event is newly identified, the surveyor will take the following steps: n Inform the practice CEO that the event has been identified n Inform the CEO the event will be reported to The Joint Commission for further review and follow-up under the provisions of the Sentinel Event Policy Shading indicates a change.Sentinel Event (SE) Date of Publication:Ī sentinel event (SE) is a patient safety event (not primarily related to the natural course of the patient’s illness or underlying condition) that reaches a patient and results in any of the following: The Joint Commission’s Response Patient safety specialists from The Joint Commission assess the acceptability of the practice’s response to the sentinel event, including the thoroughness and credibility of any comprehensive systematic analysis information reviewed and the practice’s corrective action plan. The Joint Commission must receive a request for review of a practice’s response to a sentinel event using any of these options within five business days of the self-report of a sentinel event or of the initial communication by The Joint Commission to the practice that it has become aware of a sentinel event. Interview and review of relevant documentation including, if applicable, the patient’s medical record, to evaluate the following: n The process the practice uses in responding to sentinel events n The relevant policies and procedures preceding and following the practice’s review of the specific event, and the implementation thereof, sufficient to permit inferences about the adequacy of the practic. Further, reporting the event enables the addition of the “lessons learned” from the event to be added to the Joint Commission’s Sentinel Event Database, thereby contributing to the general knowledge about sentinel events and to the reduction of risk for such events in many other practices.
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