Policy Manual


Critical Incidents      

Type: Procedure                 Category: Service Delivery                 Level: Community Care 

Parties: Community Care Employees and Contractees

Printer Friendly Version: http://apps.comcareme.org/policymanual/default.aspx?code=3.MEP.17&nonav=yes

Supporting References: COA Standards RPM 2.02, 2.03

Parent Effective Date Approval Level Revision Dates Last Reviewed
N/A  3-1-1999  Executive Director  11/95; 5/97;5/08;10/08  10-1-2008
Related Document Code Related Document Name Type

Procedure:  .

1.      Special Circumstances include, but are not restricted to: 

  • Psychotropic medication refusals
  • Indications of significant boundary issues between a client and provider
  • Client escalations
  • Disclosures
  • Suicide threat without plan or means
  • Atypical behaviors
  • Action or inaction by provider which causes harm or injury to client
  • Theft or destruction of property
  • Acts of violence  

2.      Emergencies include, but are not restricted to:

  • Suicide threat or attempt with plan and means
  • Psychotropic medication error
  • Runaway
  • Accidents resulting in injury
  • Any special circumstance listed above that are considered critical or put clients or providers at serious risk
  • Occupational exposure
  • Toxic or hazardous chemical exposure  

3.      Immediately upon becoming aware of an incident, providers shall take all necessary and appropriate action to ensure the safety and welfare of the client, assist the client and/or family of the client to deal adequately with the situation, and provide support. Such actions shall be taken with the knowledge and concurrence of the client�s treatment providers and/or emergency pager support. Because each client's situation is unique, the specific approach used in each case should be unique. It is the responsibility of theproviders to design an emergency and/or contingency plan resulting in providers working with a client having pre-knowledge and understanding of least restrictive but effective intervention measures. 

4.      Immediately, or as soon as possible, after an incident has been appropriately addressed, the provider involved shall inform his/her supervisor or the staff person on call. The supervisor or on-call person contacted will assist as needed to help the provider carry out such actions as are necessary to provide appropriate intervention and/or emotional support to the client, provider, and/or other affected persons. Because each client and provider is different and responds differently to such situations, a specific approach taken in a given situation should be based upon the needs of the client and provider involved. 

5.      As soon as possible after the incident (not more than 24 hours), or becoming aware of the incident, the provider shall complete a Community Care Critical Incident Report and submit to his/her supervisor or the appropriate Case Coordinator. The Critical Incident Report shall be filled out completely using objective, observable, measurable language. Any witnesses to the incident should sign the form in the space provided and can also complete a separate Critical Incident Report.  

6.      The writer will submit to report to the Clinical Supervisor, or designee, for a quality assurance review, debriefing and written recommendations. The report will then be filed in the client's record with a copy being sent to the legal guardian (or other non-agency case manager or guardian when appropriate). 

7.      The client�s providers shall review each Critical Incident in team meetings. It is imperative that each team member is aware of all critical incidents, interventions used, results of interventions, and possible plans for similar incidents. 

8.      The Clinical Supervisor, or designee, upon review of Critical Incident Reports, may address possible legal or liability issues involved. This person will also make recommendations for further investigation or support to client or provider (i.e., consultation with MANDT trainers; development of a contingency or emergency plan; changes in Community Care policy, procedures, or practice; etc.).