There are a handful of approved changes coming to RL that impact all forms. You will notice these changes as you submit new Incidents into RL. These changes are effective April 22, 2025.

Changes to Existing Form Fields

• We are aligning the language we use in RL to align with National and International Patient Safety Standards.
• The term “Occurrence” will be replaced with “Incident” to describe or reference patient safety events. Patient safety incident language aligns with National and International standards.

What Fields in RL Are Being Renamed?

• The “MRN/Chart #” field has been renamed to be more inclusive of other patient identifiers. The new field name is “MRN/Chart #/CR#/PCR Number”.
• “Title” has been renamed to “Title/Position”
• “Do you believe this is a Critical Incident” has been renamed to “Do you believe this should be reviewed as a potential Critical Incident?”

What Fields in RL Are Being Moved?

• “How was event discovered?” has been moved to a different section of the form. It can now be found after the “Entered Date” field.
• “Your Suggestions for Prevention” has been moved to the Details of Event section of the form.

What Fields Are Now Mandatory?

“Date of Birth” (DOB) when “Type of Person Affected” is one of the following:

• Client
• Inpatient
• Out-Patient
• Resident

Why Did we Make DOB Mandatory? 

It’s information that is usually known and helps us to categorize patient safety data in a meaningful way. For example, is a certain age group more likely to experience a type of safety event in a specific clinical environment?

What if I Don’t Know the DOB?

This could occur, and the system will allow us to enter a standard date when DOB is unknown. The system will provide instructions on what to enter.

What Fields Did we Eliminate?

To simplify and support patient safety incident reporting, the working group was asked to reflect on what details are essential for quality improvement. Our goal was to collect only the necessary information, as the health record remains the formal spot for documentation of the incident. 

The following fields were eliminated on all forms:

• Current Admission Date
• Likelihood of Recurrence
• Classification of Party
• Entered Date
• Did the event require an unplanned or extended hospitalization?
• Did the event result from the individual’s underlying health condition?
• Was the event a risk inherent in providing health services?

Identifying Contributing Factors involved in patient safety incidents is important because this information can be used to reduce the risk of something similar happening again. 

Using a Contributing Factors field also supports the ‘use standard words’ trend in quality improvement reports.

Documenting Immediate Actions following a patient safety incident helps communicate how the event was managed and reflects our standards of practice. The Contributing Factors and Immediate Actions lists are being updated to ensure that they are factors we address with quality improvement activities, and are specific to the safety event categories and/or event subtypes.

In every RL form, a new Critical Occurrence question will ask you “Do you believe this event should be reviewed as a potential Critical Occurrence?”

Critical Occurrences (CO) occur when there has been:

• Serious harm to a non-patient (e.g., employee, visitor, student)
• An incident that could affect public confidence, attract media attention, or involve litigation
• An Emergency or disaster event, such as facility evacuations

If the answer is “yes” to any of these statements, the event will be reviewed as a potential critical occurrence.
If a CO is verified, Health Authorities must report to Manitoba Health within 24 hours. 

To align safety event categories and standard details collected, this form has had significant changes to make it easier to complete.  Key changes include: 

• Introduction of subcategories of specific event types
• The Medication/Fluid search table has been changed to a drop-down list. This list has generic drug names and you can start typing in the leading letters of the medication/fluid to filter the list.
• Simplified lists based on the analysis of 5 years of trends of submitted patient safety events. This was done in consultation with our Provincial partners or working groups. 
• Introducing an “Is this a Study Medication” Yes/No question when a drug is administered.
• Type of Regimen field is added to support incidents in CancerCare.

Medication and Fluid safety incidents are a leading event category for patients. It is important to identify the medication or fluid involved in the incident and to answer key questions for system analysis.

These event forms have been updated based on Provincial working group feedback, analysis of incident trends, and reflection on Accreditation Standards.

Pick lists have been reduced and updated to ensure we are asking the essential questions for quality improvement purposes. 

Collaboration with experts on the subject of blood product administration occurred and great work was achieved in eliminating duplication in reporting. Picklist options have been reduced by approximately 66 optional answers!

• “Type of Blood Product” list is now mandatory and was shortened to the following options:
  • albumin
  • blood
  • immunoglobulins
  • Plasma
  • platelets
  • Rhlg (WinRho)
  • Other (specify)

Shared Health Diagnostic Services will be rolling out RL for patient safety incident reporting in October 2025.  Based on their reporting and accreditation needs, updates have been made to the Diagnostic Imaging and Lab/Specimen RL forms for pre-analysis and post-analysis incidents. Further updates to these RL forms will occur at a later date.

Delays in communication and taking action on Critical Results have resulted in serious harm to patients, so updates to these forms include more event categories and a new question about reporting and communication of critical results.

• Specific Event types, including new sub-categories, have been updated. 
• Contributing factors have been updated based on identified trends and advice from experts and a working group
• A new field, “Did this event involve a Critical Result?” has been added to both forms. This will help to identify incident trends and contributing factors that are specific to issues with acting upon critical lab or imaging results.
• In the Diagnostic Imaging form, a new field for DIN (Drug Inventory Number) has been added for contrast reactions, to support mandatory reporting to Health Canada when a serious patient outcome occurs
• Some optional fields have been removed and in general, drop-down lists have been made more concise to make the forms easier to complete in a timely manner.

Infections can be a leading cause of patient harm and they should be reported as a safety incident when they are acquired during healthcare services.  

The infection form has been updated to capture more specific details, such as the type of Healthcare Associated Infection:

• Blood stream infection
• Catheter-associated urinary tract infection
• CLABSI/Central Lines
• Respiratory Tract Infection
• Surgical Site Infection
• Etc.

The Covid-19 form will be deleted and is now an option for selecting under infection details -Communicable Disease Type. 

Environmental or facility issues (such as building accessibility, insect or rodent issues, walking surface issues, or obstructed pathways) can be best captured under this form. 

Some examples of events captured under this form are:

• General Facility Equipment issues
  • Damaged/faulty/worn
  • Quality check failure
  • Equipment availability
• Facility Equipment out of service.
  • CT
  • MRI
  • X-Ray
  • Elevator

General updates for specific event types have occurred and include the follow categories:

• Lost or missing item
• Unauthorized activity
• Bed or crib entrapment
• Accidental injury

Code calls are now removed from the event lists and are described in plain language, for example missing person/patient. Initiating a code response to a situation can now be captured under Immediate Action. 

Violent behaviours, such as physical or verbal aggression, have been moved to the new Behaviour form. 

To better capture patient safety incidents that involve behaviours that escalate to become safety concerns, we are introducing this new behaviour form.  Contributing factors have been updated based on the input of front-line and mental health team members, both before and during the behaviour of concern.