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Never events are serious failures of care that should never happen in hospitals, such as surgery on the wrong site or sexual assault. Hospitals must report and review them to prevent future incidents. The list of never events is periodically updated, and hospitals may face legal liability and negative publicity if they occur. Some doctors criticize the list, arguing that some events are difficult to prevent.
Never events are problems that should never occur in a hospital because they represent significant failures of care. They include things like sexually assaulting patients, accidentally releasing a child to the wrong person, or having surgery done on the wrong site. If a hospital encounters one of the outcomes on a list of never-recorded events, it may need to be reported and may have other obligations such as undergoing a mandatory review to find out why it happened and prevent an incident in the future.
The concept of never events was the result of pushes for health care reform in the early 2000s, when advocates recommended identifying a list of unforgivable events and outcomes in hospital settings to better monitor performance in medical settings. The initial list included 27 items and people review it periodically to reflect changing attitudes towards hospital care with an ever increasing number of items. When such events occur in a hospital, the response may include apologizing to the patient, waiving any treatment costs associated with the poor outcome, and putting in better controls to prevent such situations from happening again.
Usually, never events are situations where patients are clearly suffering due to negligence or inattention. If a patient’s life or health is threatened because someone fails to observe basic procedures, or a patient experiences psychological distress, as might happen if a hospital implanted the wrong embryo in a patient, there is a possibility that it could be considered an event never. For hospitals, such events create significant legal liability because if the patient takes the matter to court, the hospital will likely lose. Hospitals often try to reach an agreement to keep the situation out of the news.
Hospital rankings depend on their performance, and a history of reporting never events can push a hospital further down the road when rating agencies rate it. This can result in negative publicity for the hospital, resulting in reduced patient interest and revenue. Hospitals can also have trouble getting medical malpractice insurance when their ratings slip. Insurance providers may also refuse to offer coverage for ever events on the basis that they are the responsibility of the care facility.
Some doctors criticize the inclusions on this list, arguing that some may be extremely difficult to prevent. For example, death or serious disability from a fall is an event not seen on most lists, yet it is functionally impossible to prevent patient falls even with impeccable safety procedures.
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