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 Provider Manual

REPORTING ADVERSE CRITICAL INCIDENTS
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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.

 
 
 
 
   
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