Welcome to the EMS Near Miss Reporting Tool developed by the Center for Leadership, Innovation and Research in EMS in cooperation with the National Association of Emergency Medical Technicians (NAEMT). This tool has been created for EMS practitioners to anonymously share near-miss information by answering a series of questions in an online format. The data collected will be analyzed and possibly used in the development of EMS policies and procedures, as well as for the purpose of training, educating and preventing similar events from occurring in the future. No individual responses will be shared or transmitted to other parties.
Thank you very much for reporting your EMS Near Miss incident. The information you provide will contribute to saving lives in the future.
EMS Near Miss Event: An unplanned event that did not result in injury, illness, or damage, but had the potential to do so. Only a fortunate break in the chain of events prevented an injury, fatality or damage. EMS Event Resulting in Illness, Injury or Damage: This tool is NOT designed to collect events involving illness, injury or damage. Those events should be reported to your EMS agency as directed by your agency policy.
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DETAILS ON EMS ORGANIZATION WHERE NEAR MISS OCCURRED
DETAILS ABOUT PRACTITIONER PRIMARILY INVOLVED IN NEAR MISS EVENT
NEAR MISS EVENT INFORMATION
Was there anything unusual immediately preceding the Near Miss event that led to the error?
NEAR MISS EVENT DESCRIPTION
Describe the event.
(Describe the event in the space provided. Your narrative will be reviewed for quality and content. A reviewer will remove all identifying department indicators, names or other information that may identify you or your department. In the next section, you will be asked for suggestions on preventing similar events.)
Keep in mind the following topics when preparing your narrative: Chain of events, Communication, Decision making, Equipment, Incident command, Role, Sleep patterns, Situational awareness, SOP / SOG, Staff, Task allocation, Teamwork, Training, Weather.
LESSONS LEARNED
Describe the lessons learned as a result of the incident.
(What lessons were learned? What are your suggestions to prevent a similar event? What actions can correct the situation? This will be reviewed for quality and content. A reviewer will remove all identifying department indicators, names or other information that may identify you or your department.)
To make an anonymous report on an EMS incident, please click one of the following links below:
Near Miss Event
Patient Safety Event
Line of Duty Death Event
Center for Leadership, Innovation and Research in EMS • P.O. Box 2286 • St. Cloud, Minnesota 56302 888.603.4426 • 320.251.8154 (fax) • Contact Us