Report calls for national errors reporting system

The National Quality Forum (NQF) recently announced the availability of a report that it says could be used to form the basis for a national, state-based adverse event reporting system.

Titled "Serious Reportable Events in Healthcare: A National Quality Forum Consensus Report," the report and accompanying list of serious medical errors could form the framework of a system that allow health care providers to report medical errors in a consistent way, says Kenneth W. Kizer, MD, NQF president and CEO.

"Events, such as wrong-site surgery, medication errors, and infant discharges to the wrong person, occur more frequently than the public would like to believe," Kizer says. "Utilizing the list can be a valuable tool for making health care safer for all patients. Focusing on these serious adverse events should lead to improvements in systems and processes that will minimize their future occurrence."

The report identifies 27 adverse events in six major categories: Surgical Events, Product or Device Events, Patient Protection Events, Care Management Events, Environmental Events, and Criminal Events. Also identified are standardized definitions of key terms that are necessary if the list is to be used in a uniform manner across the country.

Information on ordering the report can be found at