Safety

Patient Safety Glossary Of Terms
TERM DEFINITION
Accident An event that involves damage to a defined system that disturbs the ongoing or future output of the system
Active error An error that occurs at the level of the frontline operator and whose effects are felt almost immediately
Adverse event An event that results in unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient
Adverse Describes a negative consequence that results in unintended injury or illness, which may or may not have been preventable
Adverse drug event Any incident in which the use of a medication at any dose, a medical device, or a special nutritional product may have resulted in an adverse outcome in a patient
Adverse drug reaction An undesirable response associated with use of a drug that either compromises therapeutic efficacy, enhances toxicity, or both
Associated with Means it is reasonable to initially assume that the adverse event was due to the referenced course of care; further investigation and/or root cause analysis of the unplanned event may be needed to confirm or refute the presumed relationship
Communication A process by which information is exchanged between individuals through a common system of symbols, signs, or behavior
Composite measure A combination of two or more individual measures in a single measure that results in a single score
Culture The integrated pattern of human knowledge, values, belief, and behavior that depends upon the capacity for learning and transmitting knowledge
Disability A physical or mental impairment that substantially limits one or more of an individual’s major life activities
Effective Providing care processes and achieving outcomes as supported by scientific evidence
Environment The circumstances, objects, or conditions surrounding an individual
Error The failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim (commission). This definition also includes failure of an unplanned action that should have been completed (omission).
Event A discrete, auditable, and clearly defined occurrence
Failure to rescue Death among patients with treatable serious complications
Fall A sudden, unintended, uncontrolled downward displacement of a patient’s body to the ground or other object.
Handover The accurate, clear, and complete communication about a patient’s condition, care, treatment, medications, services, and any recent or expected changes between different caregivers or providers
Harm Any physical or psychological injury or damage to the health of a person, including both temporary and permanent injury
Healthcare acquired infection (HAI) Infections that patients acquire while receiving treatment for medical or surgical conditions. They are associated with a variety of causes, including the use of medical devices, complications following a surgical procedure, transmission between patients and healthcare workers, or the result of antibiotic overuse.
Healthcare facility Any licensed facility that is organized, maintained, and operated for the diagnosis, prevention, treatment, rehabilitation, convalescence, or other care of human illness or injury, physical or mental, including care during and after pregnancy.
Incident A patient safety event that reached the patient, whether or not the patient was harmed.
Informed consent A process of communication between a patient and healthcare professional that results in the patient’s authorization or agreement to undergo a specific medical intervention
Leadership A process by which a person sets direction and influences others to accomplish a mission, task, or objective, and directs the organization in a way that makes it more cohesive and coherent
Mandatory reporting Legal requirement for physicians and other professionals providing health services to report suspected incidents of abuse and neglect.
Medication error Any error occurring in the medication-use process
Mitigation An action or circumstance which prevents or moderates the progression of an incident towards harming a patient
Near miss An event or a situation that did not produce patient harm, but only because of intervening factors, such as patient health or timely intervention
Outcome In healthcare, an outcome may be measured in a variety of ways, but it tends to reflect the health and well-being of the patient and the associated costs of care
Patient centered Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions
Patient safety The prevention and mitigation of harm caused by errors of omission or commission that are associated with healthcare, and involving the establishment of operational systems and processes that minimize the likelihood of errors and maximize the likelihood of intercepting them when they occur
Patient safety events A process or act of omission or commission that resulted in hazardous health care conditions and/or unintended harm to the patient.
Patient safety practices Discrete and clearly recognizable processes or manners of providing care that have an evidence base demonstrating that they reduce the likelihood of harm due to the systems, processes, or environments of care.
Preventable (event) Describes an event that could have been anticipated and prepared for, but that occurs because of an error or other system failure
Process The activities that constitute healthcare, usually carried out by professional personnel, but also including other contributions to care, particularly by patients and their families
Quality The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
Restraint Any method of restricting a patient’s freedom of movement that: is not a usual and customary part of a medical diagnostic or treatment procedure to which the patient or his or her legal representative has consented; that is not indicated to treat the patient’s medical condition or symptoms; or that does not promote the patient’s independent functioning
Risk Possibility of loss or injury
Safe practice Practices that have been demonstrated to be effective in reducing the occurrence of adverse healthcare events
Safety The condition of being free from harm or risk, as a result of prevention and mitigation strategies
Sentinel event 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. Such events are called “sentinel” because they signal the need for immediate investigation and response.
Serious (event) Describes an event that results in death or loss of a body part, disability or loss of bodily function lasting more than seven days or still present at the time of discharge from an inpatient healthcare facility or, when referring to other than an adverse event, a non-trivial event
Structure The conditions under which care is provided
Surgery An invasive operative procedure in which skin or mucous membranes and connective tissue is incised or an instrument is introduced through a natural body orifice

 Surgery on the wrong body part

Surgery performed on a body part that is not consistent with the correctly documented informed consent for that patient
 Surgery performed on the wrong patient Surgery performed on a patient that is not consistent with the correctly documented informed consent for that patient
 Surgical site infection An infection that occurs within 30 days of an operative procedure
  Timely Reducing waits and sometimes harmful delays for both those who receive and those who give care
  Usually preventable   (event) Recognizes that some of these events are not always avoidable, given the complexity of healthcare; therefore, the presence of an event on the list is not an a priori judgment either of a systems failure or of a lack of due care