REPORTING ADVERSE CRITICAL INCIDENTS
Critical incidents are clinical events or outcomes that may require further analysis involving HealthChoices eligible consumers seeking or receiving services under VBH-PA administered plans. They also include incidents that occur during a patient’s transition to home or an alternative level of care. Tracking of critical incidents is a contractual requirement for VBH-PA with the Counties, DPW, and our providers, so it is important to report an occurrence promptly.
Notification to VBH-PA that a critical incident has taken place must be done telephonically or by facsimile to a Service Manager or other VBH-PA staff as soon as reasonably possible, but ideally within 24 hours. Written supplemental notes or a copy of clinical records may be requested. Please use the Critical Incident Log to report all occurrences.
Critical incidents include but are not limited to the following events occurring within any treatment setting:
| Code | Adverse Critical Incidents | Critical “Tracking” Incidents |
|---|---|---|
| 01 | Completed suicide while in any level of care, and attempted suicide while inpatient | Attempted suicide at any other level of care than inpatient |
| 02 | Completed homicide while in any level of tx | Attempted homicide in any level of care |
| 03 | Death by any cause while inpatient for psychiatric /substance abuse treatment | Death by any cause while in any other level of care |
| 04 | Allegations of sexual or physical abuse/neglect by a provider or non-consensual sex between consumers | Allegations of sexual or physical abuse/ neglect by non/provider and consensual sex between consumers while in a facility |
| 05 | Assaults while in a facility that require serious medical treatment | Assaults while in a facility that require minor or no medical treatment |
| 06 | Absent without leave and at risk to self or others | Absent without leave with no apparent serious risk |
| 07 | Undesirable events inconsistent with routine patient care of a serious nature (adverse medical complications, inebriation, etc.) | Undesirable events inconsistent with routine patient care of a moderate nature |
| 08 | Breach of Confidentiality | |
| 09 | Parents or guardian taking child AMA from any inpatient setting with child at risk due to AMA (kidnapping, etc.) | Parents or guardian taking child AMA and needing monitoring to ensure appropriate services are in place |
| 10 | Serious accidental injuries either in a facility or a providers office | Non-serious accidental injuries either in a facility or in a providers office |
| 11 | Medication/treatment errors causing severe or potentially severe harm or distress to consumer | Medication/treatment errors not resulting in severe or potentially severe harm or distress to consumer |
| 12 | Adverse reactions to medication/treatment causing severe or potentially severe harm or distress to consumers (NMS, etc.) | Adverse reactions to medication/treatment of a moderate or minor nature |
| 13 | Fire setting/Property damage resulting in life threatening risk to self or others, or causing major damage while in a facility | Fire setting/Property damage without major risk or damage while in a facility |
| 14 | Any condition that results in temporary closure of a facility | |
| 15 | Possession of a deadly weapon while in any facility at all levels of care | |
| 16 | Outbreak of a serious communicable disease | |
| 17 | Other | Other |
| 18 | Administrative Discharge | |
| 19 | Any actual or proposed litigation in any case |
If you are in doubt that a critical incident has occurred, please notify the VBH-PA Risk Management Department so that the information can be reviewed.
