Key concepts

While being treated, patients hope that their health-related problems will be appropriately handled and healthcare professionals trust that their procedures, equipment, and training should be used in good working order and in the proper way. However, sometimes an incident occurs.

A patient safety incident (in this manual referred as an incident) is an event or circumstance which could have resulted, or did result, in unnecessary harm to a patient. Incidents can arise from either unintended or intended acts. ¹

An incident can be: 

• a near miss – an incident which did not reach the patient (e.g., detecting a wrong dose medication error before the patient take it).
• a no harm incident – reaching the patient but causing no discernible harm (e.g., infusing a wrong unit of blood, which was not incompatible). 
• an adverse event (harmful incident) – incident that results in harm to a patient (disease, injury, suffering, disability, or death). ^₁

The occurrence of healthcare incidents may depend on different situations. First of all, it is important to highlight the distinction between “violation”, “negligence” and error. An error is a failure to carry out a planned action as intended or application of an incorrect plan. Thus, it is unintentional. On the contrary, a violation is a deliberate deviation from an operating procedure, standard or rule. ^₁ Patient neglect is defined when healthcare professional flops in attending to the patient needs.₂

1. World Health Organization. The conceptual framework for the international classification for patient safety – final technical report. Geneva: World Health Organization; 2009. 

2. Reader TW, Gillespie A. Patient neglect in healthcare institutions: A systematic review and conceptual model. BMC Health Serv Res. 2013;13(1).