| I Who: Who was/were the ameliorator/s (can code multiple, if needed) |
1: Patient/Patient‐Related |
Patient, family member, patient representative |
| 2: Clinician |
Physician, physician's assistant, nurse practitioner |
| 3: Nurse |
RN, MA, LPN |
| 4: Office staff |
Front office staff, billing, administration, or medical records |
| 5: Lab or lab personnel |
Laboratory technician |
| 6: Pharmacy or pharmacist |
Pharmacist, pharmacy technician |
| 7: Radiology/radiology tech |
Radiologists, radiology technician |
| 8: Other |
Any other person not in the above categories |
| II What: (a) Was the amelioration expected, typical action; OR unexpected above and beyond. If patient was the ameliorator, no code needed. |
A: Most people, most times |
Most people, most of the time would take this action; it would be expected for most people to do this under the event circumstances. |
| B: Over and above |
The action taken is exceptional and goes above and beyond what would normally expect (“Wow! I didn't expect that”) |
| C: Insufficient information |
Use to indicate there seems to be insufficient information to code the event in this domain. |
| III What: (b) What exactly did the ameliorator do (eg, phone call, double‐check, asked questions, etc) |
[open code or in vivo code] |
Descriptive codes to get a sense of types of things people do when they ameliorate (eg, phone call, asked extra questions, double‐checked, actually followed protocol) |
| IV When: At what point in the process (ie, the entire loop for an event procedure or activity) did the amelioration occur? |
PRE |
Amelioration took place before event process started (eg, system change to prevent a future error; corrected medical record to prevent future error) |
| EARLY |
Amelioration took place early in the event process (eg, MD noticed wrote wrong dose on Rx and corrected before patient left) |
| MID |
Amelioration took place in middle of process (eg, pharmacy noticed dose was wrong, clarified with clinic, then dispensed correctly) |
| LATE |
Amelioration took place late in event process (eg, patient noticed that dispense pills were different and clarified before taking) |
| V. System change? |
SYSTEM |
Use to indicate a change made to system or protocol or practice (ie, implemented an office‐wide change), either as a part of the amelioration or as a result of the event |
