Transparency of reporting of surgical Never Events

What is it about?

Never Events are well defined adverse events that must be reported by hospitals. This study looked at the transparency of public reporting and quality of investigation following Never Events in English hospitals. Although there were notable examples of excellence, many hospitals either gave no / limited information about the Never Events or appeared to carry out only superficial investigations.

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Why is it important?

If safety in healthcare is to improve then organisations have be willing to learn from their own mistakes and those of others. If hospitals are not sharing information when problems occur, or not investigating properly then there is a risk that future patients will suffer harm unnecessarily.