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Reporting Committee Summaries

Educational Resources

Reporting Committee Summaries

The NCPS Reporting Committee is an interprofessional group of clinical subject matter experts (i.e. nurse, pharmacist, allied health professionals, physician and physician assistant). The committee meets on a quarterly basis to review selected reported events which have been de-identified. They discuss identified causal factors, the overall thoroughness of the information reported, and identify risk mitigation strategies to share with all NCPS members.

The Reporting Committee Summaries provide a comprehensive overview of several of the safety events that were discussed, and are developed within the framework of an organizational self-assessment tool which asks, "Could this happen in your organization?" This framework, and the inclusion of links to best practice recommendations and other patient safety-related resources enables our members to proactively identify risk and develop mitigation strategies to prevent the events from occurring in their healthcare setting. 

The list below displays the topics that have been included in reporting committee summaries that are available to our members. 

NCPS members can click on the title to login and access these Member Resources.

  • This summary focuses on the importance of verifying/validating the formatting of lab test results in the EHR, having a comprehensive pre-op checklist, and the importance of cultivating an environment where each colleagues understands the important part they play in providing safe patient care.

  • This summary highlights why patients should be encouraged not bring their home medications with them to the hospital for an inpatient stay; also the importance of a comprehensive discharge process/checklist that RNs performing this task are trained to complete.

  • The Q3 2021 summary focuses on risk mitigation as it relates to caring for non-English speaking patients.

  • This summary focuses on improving patient safety during procedures involving insertion of medical devices. It includes a primer on the importance of examining human factors in medical error, and risk mitigation strategies to improve system safety. It also contains a facility self-assessment, “Could this happen in your organization?” with links to valuable resources.

  • This summary focuses on risk mitigation as it relates to reporting critical results of tests and diagnostic procedures on a timely basis.

  • The Q4 summary focuses on risk mitigation as it relates to working with students during their clinical rotations.

  • The Q3 2020 summary provides an organizational self-assessment of risk mitigation strategies focused on patient education; highlighting the importance of Teach Back and other strategies aimed at promoting health literacy.

  • The Q2 2020 summary provides an organizational self-assessment of risk mitigation strategies focused on specimen handling, and test resulting.

  • The Q1 2020 summary provides an organizational self-assessment of risk mitigation strategies focused on obtaining accurate allergy history, and medication errors related to infusion rate and communication failures.

  • The Q4 2019 summary provides an organizational self-assessment of risk mitigation strategies focused on fall risk reduction in the emergency department, on a medical/surgical unit, and in the OR.

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