From Sentinel Event to Systemwide Improvement: Development of the Behavioral Health No Harm Index.

Behavioral health has largely remained outside the mainstream of harm measurement science. Traditional safety measurement tools such as the Global Trigger Tool or the Preventable Harm Index are not adapted for psychiatric care, where harm may manifest differently than traditional acute medical care...

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Publicado en:Joint Commission Journal on Quality & Patient Safety Vol. 52; no. 5/6; pp. 201 - 208
Autores principales: Ng, Norman, Durst, Linda, Hasan, Omar, Sirois, Mike, Strout, Tania
Formato: research Journal Article
Publicado: Elsevier B.V. May2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2026
      vid: 52
      iid: 5/6
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      pub: Elsevier B.V.
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        193615217
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        10.1016/j.jcjq.2026.02.003
        193615217
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        atl: From Sentinel Event to Systemwide Improvement: Development of the Behavioral Health No Harm Index.
      aug:
        au:
          Ng, Norman
          Durst, Linda
          Hasan, Omar
          Sirois, Mike
          Strout, Tania
      sug:
        subj:
          Sentinel Event
          Treatment Errors Prevention and Control
          Risk Management
          Patient Safety Standards
          Conceptual Framework
          Quality Improvement
          Psychiatric Care
          Human
          Validation Studies
          Descriptive Statistics
          Inpatients
          Outpatients
          Multidisciplinary Care Team
          Quality of Health Care
          Mental Health Services
          Organizational Culture
          Residential Facilities
          Clinical Indicators
      ab: Behavioral health has largely remained outside the mainstream of harm measurement science. Traditional safety measurement tools such as the Global Trigger Tool or the Preventable Harm Index are not adapted for psychiatric care, where harm may manifest differently than traditional acute medical care settings. The aim of this study was to design, implement, and evaluate a Behavioral Health No Harm Index (BH-NHI) across inpatient, outpatient, and residential settings to enhance error detection, increase safety event reporting, develop a baseline for harm measurement, and establish a standardized review process for psychiatric care. Following a sentinel event in summer 2022, a multidisciplinary team developed the BH-NHI through literature review, stakeholder engagement, and iterative refinement. The index was implemented across all MaineHealth Behavioral Health (MHBH) settings with high reliability organization (HRO) training, staff education, and the launch of the "Good Catch" initiative. Analysis of safety event reports across three fiscal years (FYs)—October 2021 through September 2024—examined baseline trends in harm events, severity levels, and event categories. Safety event submissions increased 88.2% from FY22 to FY24, reflecting our goal to increase harm event reporting. Concurrently, the rate of BH-NHI events decreased from 26.7 to 18.3 per 1,000 safety events submitted. Variation in the BH-NHI event frequency represents early descriptive findings during initial implementation, and additional data will be required to establish a casual harm reduction. The BH-NHI provides a replicable framework for behavioral health organizations to systematically increase detection and review harm events while building upon available literature related to harm measurement science and fostering a proactive safety culture aligned with HRO principles.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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