1. Ridgeview Ranch Critical Incident Training

2. Purpose of Reporting Purpose:To promote timely communication of information regarding significant incidents through the appropriate chain of command; to ensure that all appropriate individuals and agencies are notified; and to provide a medium for ongoing review of staff and management actions related to significant incidents.

3. Definitions   Incident: An incident is an occurrence which is not consistent with the routine operation of Reality or the routine care of a particular patient including any occurrence which threatens the safety of the patients, families, visitors, staff or any occurrence which presents elements of risk or liability to Reality.

4. Definitions Continued   Sentinel events: An unexpected occurrence involving the death or serious physical or psychological injury or the risk thereof. Serious injury specifically includes loss of limb or function. A sentinel event is also one that could potentially result in litigation.   Remedial action: Interventions or actions by the reporter or other employee that appropriately responds to the incident.

5. Examples of Critical Incidents 1. 1.Medication error 2. 2.Use of seclusion or restraint 3. 3.Incidents involving injury 4. 4.Communicable disease 5. 5.Infection control 6. 6.Violence or aggression 7. 7.Destruction of property 8. 8.Vehicular accidents 9. 9.Biohazardous accident 10. 10.Abuse or neglect

6. More Examples 11. 11.Elopement and/or wandering 12. 12.Suicide or attempted suicide 13. 13.Sexual assault 14. 14.Unauthorized use or possession of legal or illegal substances 15. 15.Use or unauthorized possession of weapon 16. 16.Other sentinel event

7. How To Report 1. 1.Any employee who has first-hand knowledge of an incident is responsible for completing a Critical Incident Report form immediately after observing or upon learning of the incident and after eliminating potential hazards and obtaining any necessary emergency assistance. 2. 2.The form should be completed through to the section that reads “Recommended follow-up”. The completed form should be signed, dated and then submitted to the Operations Manager or Program Director or designee.

8. How to Report 2.The employee should include: a. a.The date and time of the incident b. b.The name of the person reporting the incident c. c.The location of the incident d. d.The name of other persons involved (initials of clients) e. e.Indication of the type of incident (check boxes) f. f.Narrative (Write a brief but detailed account of the incident): The report writer should write a brief synopsis indicating the facts of the incident only. The synopsis should be brief but very detailed. g. g.Names or initials of witnesses h. h.A brief description of remedial action taken, if any i. i.The employee’s signature and date of report

9. 3. 3.The Operations Manager or Program Director or designee should review the incident and recommend follow-up action or distribute as appropriate. 4. 4.The Operations Manager or Program Director or designee shall be responsible for reporting sentinel events to CARF and governmental bodies as appropriate.

10. Reporting 5. 5.The Operations Manager or Program Director or designee shall review all Critical Incident Reports for each quarter and submit an analysis of trends, areas for staff training and suggestions for prevention of future incidents to the Management. The Management Team will review the report and submit the review to the CQI Coordinator for inclusion in the quarterly CQI report.

11. Reporting 6. 6.The Operations Manager or Program Director or designee shall be responsible for reporting sentinel events to the CARF and governmental bodies as appropriate. 7. 7.The Operations Manager or Program Director or designee shall review all Critical Incident Reports for each quarter and submit an analysis of trends, areas for staff training and suggestions for prevention of future incidents to the Management Team. The Management Team will review the report and submit the review for inclusion in the quarterly CQI report.

12. Reporting and follow-up 8. 8.Although the Incident may be described in the progress notes of a client’s electronic medical file, neither the original nor a copy of the IR should be attached to the record. The "Incident Report" is not referred to in the client record. 9. 9.In cases where the incident is an employee related accident, the Administrative Support Manager must be notified within 24 hours. A copy of the incident report will be scanned and attached to the employee’s electronic personnel record.

13. Reporting and follow-up 10.The Incident Report in no way substitutes for any Worker's Compensation forms and/or drug screens that need to be completed.

14. Reporting and follow-up 11. 11.In the case of an emergency situation where a debriefing is deemed appropriate by the Operations Manager or Program Director, the Operations Manager or Program Director or designee will oversee the process, having approval of who will participate in the debriefing and reviewing the outcome of the debriefing in the minutes taken.

15. Questions?