Lesson 1 of 3 · about 20 min
Seriousness: the six criteria
Seriousness decides how fast a case must be reported. It is a yes or no call, and it is made on the outcome or the action needed, not on how bad the event sounds.
An event is serious if it meets at least one of these criteria:
- Results in death
- Is life-threatening, meaning the patient was at immediate risk of death at the time of the event. It does not mean the event might have caused death if it had been worse
- Requires inpatient hospitalisation, or prolongs an existing hospitalisation
- Results in persistent or significant disability or incapacity
- Is a congenital anomaly or birth defect
- Is a medically important event that may need intervention to prevent one of the outcomes above, such as anaphylaxis treated in an emergency room, or convulsions that did not lead to admission
Severity and seriousness are not the same. Severity describes intensity: mild, moderate or severe. A severe headache that resolves at home is not serious. A mild-looking event that sends a patient to hospital for three nights is serious. Case processors who confuse the two over-report some cases and miss others.
Hospitalisation needs care. A planned admission for a procedure that was scheduled before the event does not count. Admission only for observation, with no treatment and no diagnosis, is usually handled according to company convention, so check the procedure you work under. A stay in an emergency department without admission is not hospitalisation, but the event may still be medically important.
Worked example
A 58-year-old man starts a new antihypertensive. Four days later he has dizziness rated severe by the reporter. He stays home, rests, and it settles in two days. Severity: severe. Seriousness: no criterion is met, so the case is non-serious. Now change one fact: he faints, falls, and is admitted for two nights with a fractured wrist. The hospitalisation makes it serious, regardless of how the dizziness was graded.