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Patient Safety Reporting is intended only for patient safety events. These include events,
incidents, or conditions that could have resulted – or did result – in patient harm. Adverse drug
reactions should also be reported.

To submit a report, go to Report -> Patient Event and choose the closest event type based on
the guidance below. If you are unsure, submit under Management of Care Event.

Resources/Quick Reference Guides and contacts available on Mayo Clinic Patient Safety
intranet.

Other issues such as Visitor Falls, Workplace Violence, and Controlled Substance Diversion
reporting links are available online.

Event Form Examples

Blood Transfusion Product or order related

Event Administration related
Adverse reactions
Contaminated, unavailable, or
Environment/Equipment malfunctioned equipment
Event Equipment failed to be used
appropriately
Spill or disposal of hazardous
material
Medical gases
Fall Event All patient falls
Lab Event Order, collection, result, or
specimen transport related
Laboratory equipment related
Management of Care Noninvasive test or procedure
Event related
*Use to report if event Infections
type is unclear IV access Line or infiltration related
Delays
Diet or nutrition
 Medication Event All medication events
Adverse drug reaction
Pressure Injury/Skin Bruising, tears, and abrasions
Integrity Event Burns
Pressure injuries and ulcers
Safety/Security Event Patient self-harm
*In emergent Elopement
situations, first call Assault on patient
Global Security!
Surgical/Invasive Anesthesia related
Procedure Event Unplanned or unexpected surgical
or invasive procedure events

After an event, it’s alright to feel the way you do. The HELP Program is available to all Mayo
Clinic employees, and learners, who experience emotional and/or physiological impacts after an
adverse event, medical error, unexpected outcome, or any stressful patient-related event.

VigiLanz Dynamic Safety Surveillance - 2023

This document is privileged and confidential and should not be shared or distributed outside of the quality
improvement structure.