​A clinical incident is an event or circumstance that occurred during service delivery, which resulted in harm or has the potential to harm an active client. Clinical incident management is the processes for identifying, responding, notifying, prioritising, investigating, and managing the outcomes of a clinical incident. Clinical incident management also includes actions taken to prevent similar occurrences.

Implementing clinical incident management supports the NSW Health vision that people with alcohol and other drug related harms experience person-centred, safe, high quality intervention and care.

Last updated: 26 September 2022

Key points about clinical incident management

  • Clinical incident management is part of broader clinical governance systems to maintain and improve the safety and quality of health care services.

  • Clinical incident management processes outline the actions, instructions, roles and responsibilities in managing clinical incidents.

  • Clinical incident management is applicable to all organisations providing alcohol and other drug treatment services.
  • Corporate and operational incidents may also occur and there should be distinct processes in place for managing these.
  • All clinical incidents are responded to, notified, prioritised and investigated. Serious clinical incidents require a greater level of investigation, and may include investigators from outside the organisation, such as a funding and contracting agency.
  • Clinical incident management is supported by an open, transparent culture where incident reporting is encouraged, incidents are acknowledged without fear of inappropriate blame, and information is used to inform safety and quality improvements.
  • Clients, and where appropriate family, should be informed of clinical incidents they are involved in and any follow-up actions taken, and support provided as needed.
  • Clinical incidents may include medication errors, acute deterioration of mental or physical health requiring intervention, assault of a client, or a client death.
  • Clinical incident data is valuable information about the number, nature and cause of adverse events in healthcare and should be used to inform safety and quality improvements.

Practice tips for AOD service providers

  • Ensure clinical incident management policies and procedures comply with legislative and contractual requirements while being tailored to the services the organisation provides.
  • Map out clinical incident management requirements for incidents that are specific to the organisation to assist staff in understanding good incident management practice.
  • Clearly and consistently define what is and what isn’t a clinical incident.
  • Clearly define roles and responsibilities for all clinical incident management processes, including incident data analysis and development of improvement activities.
  • Provide staff with orientation, training and resources on clinical incident management.
  • Use standard clinical incident forms and checklists to guide consistent, documented and complete practice.
  • Standardise clinical incident consolidated reports to communicate with clients, staff, the governing body and funding/contracting agencies.

Further information


Email: moh-aodsafetyquality@moh.health.nsw.gov.au

Current as at: Monday 26 September 2022