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Step 3. Prioritisation (SAC rating)
Covered in this page are Range of incidents
in health care | Determine level
of response for open disclosure
The Severity
Assessment Code (SAC) is used to prioritise
all notifications, and the SAC rating is assigned
in the Incident Information Management System (IIMS).
Contact your IIMS
administrator if you need assistance using the
system.
The SAC tool determines the level of response following
notification of an incident. When applying the SAC
score, you need to consider the actual outcome
or consequence of the incident. For example, say a
patient has slipped standing from the chair and sustains
slight bruising of the forearm. In this case, the
consequence will be minimal but had
the patient sustained a hip fracture requiring surgery,
then the consequence would be major or moderate.
Range of incidents in health care
A representation of the severity of incidents is best
shown as a pyramid (see the diagram). The majority of
incidents are minimal or no-harm incidents or near misses.
At the tip of the reporting pyramid are the most serious
incidents — SAC 1 — representing less than 1
per cent of all incidents.
If you are a manager...
... it is up to you to ensure that your staff
know how to use the SAC matrix.
The notifier assigns the SAC rating in IIMS
and the manager confirms it. The SAC rating
guides the manager in prioritising which incident
they handle first.
A SAC 1 incident is of extreme risk
and requires immediate action. A Reportable
Incident Brief (RIB) must be sent to the
NSW Department of Health within 24 hours
and a Root Cause Analysis (RCA) must
be initiated.
A SAC 2 incident is high risk and must
be notified to senior management for detailed
investigation.
Determine level of response
for open disclosure
Once the SAC rating has been applied, you need to determine
the level of response for open disclosure in accordance
with the policy Open
Disclosure PD2007_040.
There are two levels of response: high level for
a SAC 1 incident and low level for a SAC 2, SAC
3 or SAC 4 incident. Irrespective of the level of response
to an incident, the patient must be fully informed within
24 hours of acknowledgement of the incident (see
Step 7. Feedback
for more).
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