Critical Incident Reporting

Welcome to Sojourner Recovery Services’ training on Critical Incident reporting procedures.  Below you will find some general information on this subject as well as agency guidelines about how we report incidents in our facilities or among our clients. If you have additional questions, please contact your supervisor or an administrator. 

The timely reporting of incidents in writing is important because details may be forgotten over time. Documentation is necessary because of follow up with legal, medical, or mental health agencies. 

Written reports of all critical incidents must be made to the Executive Vice President within 24 hours of the incident. The degree of the incident will be determined by using the criteria listed below. All incidents are referred by the Executive Vice President to the Safety Committee for additional review. Specific action may be deemed necessary/desirable by the Executive Vice President and/or the Safety Committee as patterns and trends emerge.

Routine Critical Incidents:   includes, but is not limited to, those occurrences which take place outside the normal activity of the agency and which may place staff, client, or others at some risk. The following are some examples of routine adverse incidents:

1.  Client leaving against staff advice.

2.  Suicide threats or ideation within agency facilities.

3.  Physical injury and/or clinically significant threats to a client or staff occurring on Sojourner property or during agency sponsored off-site activities.

4.  Suspicions of incidents of a sexual nature between clients (adolescents only).

5.  Suspicions of use or possession of alcohol or illegal substances on agency property or during agency sponsored activities.

6.  Medication errors.

7.  Violence or aggression.

8.  Use or possession of weapons.

Major Unusual Incidents:  a serious incident involving client/s, staff, or visitor/s of Sojourner Recovery Services. Major Unusual Incidents may involve, but are not limited to:

1.  Death or serious injury of a client or employee, volunteer or contract employee within Sojourner facilities, or during agency related business.

2.  Alleged physical, sexual or verbal abuse, exploitation, or neglect by Sojourner staff.

Reporting Procedures:

·        Incident Report Form is available on the “f” drive on the computer. Click on “Forms”, then click on “Safety and Health”, and finally “Incident Reports”.

·        Staff involved in the incident will be responsible for completing the Incident Reporting Form and attaining all police reports or other pertinent documents related to the incident. Staff involved in the incident is also responsible for documenting essential facts of the incident.

·        Staff notifies appropriate supervisor or designated on-call person to determine action steps and identify the degree of the incident.

·        Major Unusual Incidents should be verbally reported to the Executive Vice President immediately.

·        Completed forms are submitted immediately to the supervisor of the program in which the incident occurred. The Safety Officer and the Executive Vice President promptly report each incident to regulatory agencies, as required.

·        Routine Incident reports will be forwarded to the Supervisor of the program in which the incident occurred and the Executive Vice President. These will be presented to the Safety committee for trend analysis.

·        Additional steps may be taken by Administration.

Following is a copy of the Incident Report form. There is also a printable form available. The digital form should be e-mailed to Robyn Ramsey as stated at the bottom of the form. The printable form should be sent to Robyn through inter-office mail. A copy should also be sent to the facility supervisor and/or Operations Manager. As stated above, this form should be completed within 24 hours of the incident, however, it is preferable that is be completed by the end of the shift. It is important to be as detailed as possible in documenting the event.

Location of Incident:  Where did the incident occur? Which facility? Where in the facility? Did it happen off-site?

Incident Category: Who was involved in the incident? Was it a building-related incident, such as damage to the building? Was it an incident involving an agency automobile?

Type of Incident: Check all that apply.

Names of persons Involved: Include the name of all involved and their relationship to the client. Include names of all clients, if any, who were involved in the incident.

Please describe Incident in Detail: What happened? Where? Who was involved? What time was it? What staff was involved? Was there a call made to 911? If so, who responded? Police, Fire, Rescue?  Was anyone transported to the hospital or jail? Which hospital or jail were they taken to? Was the supervisor or on-call person contacted? Did any staff come to the facility?

Review the form   

Quiz Instructions:

1. Click on the link below to access the quiz

2. Print the page

3. Complete the quiz

4. Submit the completed quiz to your supervisor 

Critical Incident Reporting Quiz