c. Individuals involved (only the client whose file is being documented should be identified byname; others should be de-identified);d. Individuals notified;e. Summary statement of action taken on behalf of the organization; andf. Date incident/accident report was submitted to Quality Assurance.
*NOTE: The incident/accident report is not to be filed in the case record.)
3. All incidents/accidents are required to be reported verbally through the chain of command for the division (i.e Supervisor, Manager,Director, Vice President, and President/CEO). ThePresident/CEO must be informed within 2 hours for any incident/accident that requiresimmediate medical treatment or if the incident/accident poses a serious risk of harm to thestakeholder.4. Client Incident/Accident Reports and the Employee/Volunteer Incident/Accident Reports arecompleted and forwarded to Vice President of Quality Assurance within 24 hours of notificationof the incident. The Vice President of Quality Assurance will maintain a summary spreadsheetof all incidents/accidents received and will keep the incident/accident forms in a locked filingcabinet in the office of the Division of Quality Assurance. For performance and qualityimprovement purposes the Division of Quality Assurance will complete a data analysis of allincidents and accidents on a quarterly basis and submit the results to the appropriatePerformance and Quality Improvement Committee for review/recommendations. The followingexamples identify which incident/accident analysis reports are forwarded to:
Client Services Committee
incidents related to manual restraint (attach physical restraint form);
altercations (unruly behavior of a client)
destruction of property/vandalism;
assaults (clients, employees, volunteers, or visitors);
contraband (use or possession of illegal drugs or paraphernalia);
exposure to blood borne pathogens (need sticks, etc.);
birth/death on premises;
accidental injuries to clients, staff, visitors, or volunteers in agency facilities;
altercations (unruly behavior of an employee/volunteer/donor); and
vehicle accidents.The Chair of the appropriate Performance and Quality Improvement subcommittee will providea summary of such reports and recommendations to the PQI Committee on a quarterly basis,with an annual report to the Board of Directors.
Incident/accident reports are considered part of the agency’s risk management program. As
such they are subject to the confidentiality, records, and immunity guidelines outlined in
CCFW’s Risk Prevention and Management Plan.