Get Ut Patient Safety Sentinel Event Reporting Form 2007-2025
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How to fill out the UT Patient Safety Sentinel Event Reporting Form online
Filing a report using the UT Patient Safety Sentinel Event Reporting Form is a critical step in addressing and learning from sentinel events in healthcare. This guide provides a comprehensive, user-friendly approach to completing this form online, ensuring that users can submit the necessary information efficiently and accurately.
Follow the steps to complete the form effectively.
- Click ‘Get Form’ button to obtain the form and access it in your preferred editor.
- Begin by entering the facility information in the designated fields, including the name of the facility, the reporting person's name, email address, telephone number, and title.
- Next, proceed to the patient information section. Fill in the patient's date of birth, age, and gender, followed by the principal admitting diagnoses, the date of admission, and any known ICD codes.
- Provide a narrative description of the patient’s condition, along with the principal discharge diagnoses and associated ICD or CPT codes if applicable.
- Move to the event information section. Enter the date and time of the event, the date of determination, and categorize the type of outcome, such as death or major permanent loss of function.
- In the narrative description field, provide context for the event and specify the patient's cognitive status prior to the event by selecting the appropriate checkbox.
- Indicate the location of the patient when the event occurred and check the relevant type of occurrence, detailing the specific incident if it's not listed.
- Complete the root cause analysis and corrective action section by checking all applicable boxes related to type of harm, contributing factors, and actions taken.
- Finally, review all the entered information for accuracy. You may then save any changes made, and options to download, print, or share the form will be available.
We encourage you to complete the UT Patient Safety Sentinel Event Reporting Form online to contribute to the safety and quality of healthcare.
To report patient safety issues, fill out the UT Patient Safety Sentinel Event Reporting Form, which is designed for clarity and comprehensiveness. This form allows you to provide critical information efficiently and accurately. After completing the form, submit it according to the specific guidelines outlined by your institution. Reporting issues in this manner is crucial for creating a safer healthcare environment for all patients.
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