Medical Mutual - Health Plans for Life

Serious Reportable Events

The Clinical Quality Improvement department investigates all quality of care or service issues including Serious Reportable Events (SREs) and Hospital-Acquired Conditions (HACs). Medical Mutual follows the National Quality Forum (NQF) list of SREs, commonly referred to as “Never Events” and labeled “Sentinel Events” by the Joint Commission. As defined by the NQF, SREs are clearly identifiable, measurable and usually preventable events that result in an adverse patient outcome, such as significant harm (i.e., loss of body part, disability) and/or death. The list of SREs published by the NQF is reviewed on a quarterly basis for any changes or additions. Medical Mutual identifies HACs using the Centers for Medicare and Medicaid list of HACs.

The Clinical Quality Improvement department requests records and performs a focused review on all cases where a potential or confirmed quality of care issue was identified when the occurrence threshold exceeds established thresholds.

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