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Where COVID-19 is acquired within a healthcare setting that results in serious harm or death of a patient, the incident should be reviewed internally using the Rapid adverse event review tool – COVID-19 related deaths occurring in health services

If a health service identifies a cluster of events (more than one), it is recommended they contact the sentinel event program to discuss.

Sentinel events related to healthcare associated COVID-19 are to be notified through the sentinel event portal, with subsequent reports submitted in-line with current reporting requirements. 

We have developed a systems-focused rapid tool specifically for the review of COVID-19 related adverse events within healthcare settings.

We recommend the use of this tool for healthcare-acquired COVID-19 sentinel events as it will assist in identifying contributing systems issues and the development of system-based recommendations.  

The tool guides reviewers through the basic steps of undertaking an adverse event review to examine what happened, how it happened, and why it happened. 

If the tool is used for a sentinel event review, we recommend the tool to be uploaded to the sentinel event portal in Report Part B - Timeline and analysis diagram. Please only upload page 5 onwards (starting with the event description) to ensure that no identifying information is uploaded in the portal. 

Prior review experience would be beneficial but is not required to use the tool. If you require support in using the tool, please contact the SCV Patient Safety Review team.

For guidance on whether an event meets sentinel event notification criteria, or if you identify a cluster or events (more than one),  it is recommended you contact the Sentinel Events Program to discuss the notification.   

For further information on sentinel event reporting or the portal please visit the Sentinel Events page

Get in touch

Patient Safety Review team
Safer Care Victoria
1300 543 916
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