Understanding the terminology
The term “patient” is used in this publication to refer to the individual who is the subject of a patient safety incident. The term may also refer to the patient’s family when patient consent has been given to their involvement in the disclosure process; the patient’s substitute decision-maker where the patient lacks capacity to consent; or the patient’s legal representative when the patient is deceased.
Patient safety incident
The term “patient safety incident” is used in this publication. The World Health Organization (WHO) provides terminology to facilitate the sharing and learning of patient safety information globally.1 The Canadian Patient Safety Institute (CPSI) has adopted some of these terms.2
To support clarity and consistency, the CMPA now uses these CPSI terms:
Patient safety incident: An event or circumstance which could have resulted, or did result, in unnecessary harm to the patient.
Harmful incident: A patient safety incident that resulted in harm to the patient. Replaces the terms “adverse event” and “sentinel event.”
No harm incident: A patient safety incident which reached the patient but no discernible harm resulted.
Near miss: A patient safety incident that did not reach the patient. Replaces the term “close call.”
In Québec, the applicable legislation defines the terms “accident” and “incident.” Neither of these terms correspond exactly to the WHO terminology. “An ‘accident’ in Québec means “an action or situation where a risk event occurs which has or could have consequences for the state of health or welfare of the user, a personnel member, a professional involved, or a third person.”3 The term ‘incident,’ on the other hand, is defined as “an action or situation that does not have consequences for the state of health or welfare of the aforementioned parties, but the outcome of which is unusual and could have had consequences under different circumstances.”4 The term ‘accident’ in Québec legislation would align with the WHO term “harmful incident” whereas the term “incident” would include the WHO terms “no harm incident” and “near miss.”
- World Alliance for Safer Health Care, More than words: Conceptual framework for the international classification for Patient Safety, (Geneva: World Health Organization, 2009), accessed April 8, 2015 from http://www.who.int/patientsafety/taxonomy/icps_full_report.pdf
- Disclosure Working Group, Canadian Disclosure Guidelines: being open and honest with patients and families, (Edmonton: Canadian Patient Safety Institute, 2011), 22
- Québec, An Act Respecting Health Services and Social Services, CQLR c S-4.2, art. 8
- Québec, An Act Respecting Health Services and Social Services, CQLR c S-4.2, art. 183.2