The Opportunity 

Inconsistent reporting programs and varied definitions hinder efforts to accurately measure and report the prevalence and impact of patient safety events. 

NQF first defined Serious Reportable Events (SREs) in 2002 with the introduction of the SRE list, a set of patient safety events that are serious, largely preventable, and may be indicative of a problem with a healthcare setting’s safety systems. The list was last updated in 2011. Since that time, the healthcare landscape has changed significantly with care now being delivered in new settings and modalities. The SRE list is used across the nation by many national and state-based reporting systems and healthcare systems to: 

• Facilitate uniform and comparable public reporting 
• Enable systematic learning across healthcare organizations 
• Drive systematic national improvements in the prevention and mitigation of serious harm 
• Improve patient safety 

More than 25 states use the SRE list, or elements of it, for mandatory accountability reporting. However, in many cases, states have modified SREs and the way they are reported, making it difficult to compare across different systems. Promoting greater alignment among states will foster the ability to track, trend, and benchmark preventable patient safety events. NQF’s Focus on HARM initiative is designed to help harmonize reporting taxonomies. 

About the Project 

NQF is developing a unified, consensus-based, updated list of SREs that reflects the full range of today’s care delivery settings and modalities and fosters alignment of disparate definitions and terminologies used when interpreting harm events and subsequent reporting adherence.   

In June 2024, NQF held a public comment period and conducted a call for candidate events as part of the consensus-based process for updating the SRE list. Specifically, NQF requested public input on the draft 2024 SRE inclusion criteria and applicable care settings and encouraged the submission of candidate patient safety events meeting the updated inclusion criteria. The call received substantial engagement resulting in a total of 50 event submissions.  These submissions were reviewed and consolidated into 37 candidate events. 

In June 2024, to ensure the updated SRE list is comprehensive and reflective of today’s healthcare landscape, NQF opened a second round of public review and comment on a total of 66 candidate events to be considered for inclusion on the updated SRE list, including the 29 existing events from the 2011 SRE report.  

Throughout the project, NQF will engage Technical Expert Panels (TEPs) comprising diverse stakeholder perspectives to review the candidate events and develop clinical application guidance to foster improved identification and reporting of SREs (see Figure 1 below). 

For additional questions, please contact the project team at patientsafety@qualityforum.org