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How to Report

Reporting Safety Events

How are events reported to NCPS?

NCPS members currently follow this process for submitting adverse event report using the writeable pdf form linked below.
  1. Complete the form electronically, excluding identifying information about the patient or specific healthcare personnel involved in the event.  
  2. Complete as many fields in the form as possible, even if a root cause analysis was not conducted.  
  3. Include contributing factors, proximal causes, and actions taken to prevent future events, based on the investigation and follow up of the event.
  4. Save the completed pdf in a secure location for your own records.
  5. Send the completed form to NCPS via an encrypted email at:   
  6. Acknowledgement of receipt of report is sent from NCPS to reporting member via email within one week.
We encourage our members to report events and near events on a regular basis in order to maintain a robust reporting relationship. It is through this reporting relationship that the privilege and confidentiality protections are maintained.

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